Menopause: Treatment Options
Early in menopause, you and your doctor should discuss your symptoms and whether to treat them as they occur. You should be evaluated for your risk of getting breast cancer, osteoporosis (severe bone loss), and heart disease. If you're not at high risk for breast cancer, you may want to consider taking estrogen for a limited time, and using the lowest effective dose, which can help manage several symptoms at once. If you are at risk, other treatments are available.
Later in menopause you should focus on effectively preventing disease. Your earlier symptoms will probably disappear.
You and your doctor should form a partnership and share information that will help you make the best decisions about your health. There are many things to keep in mind, because menopause and the years that follow it usually cover the second half of a woman's life. Talk to your doctor about all of the treatment choices to decide what is right for you.
Hormone Treatment Options
Many women want to replace the estrogen their body is losing, because estrogen does relieve many symptoms of menopause. Women who still have a uterus usually take a combination of estrogen with a form of progesterone, called progestin. This is called hormone therapy (HT).
Estrogen increases the risk of uterine cancer if taken alone. If a woman has had her uterus removed, she can take estrogen by itself. This is called estrogen therapy or ET.
If you have a family history of breast cancer or have survived breast cancer, you probably should not take estrogen or HT, although not all studies support this conclusion. You also should not take estrogen if you have had cancer of the uterus, liver disease, history of blood clots, heart disease or unusual bleeding from the vagina.
Estrogen can help to reduce hot flashes, vaginal dryness, and skin changes. Estrogen is a good way to protect your bones from rapid weakening as you age.
For symptoms of early menopause:
Here are some ways to treat your symptoms without choosing HT:
Clonidine is a blood-pressure-lowering drug that is also used to reduce the frequency and severity of hot flashes.
Medroxyprogesterone acetate and megestrol acetate, progesterone-type drugs, may be used to treat hot flashes.
The SSRI (Selective-Serotonin Reuptake Inhibitor) drugs are useful in two ways - treating depression and treating hot flashes.
Counseling or support groups can also help you to handle sad, depressed, or confusing feelings you may be having as your body changes.
Vaginal lubricants, such as Vagisil or Replens, can help women with thinning vaginal tissue or dryness.
Low-dose vaginal estrogen is generally a safe way to take estrogen to solve vaginal thinning and dryness problems without substantially increasing the levels of estrogen in the blood.
Lack of desire can be helped with more open communication with your partner, creating a pleasurable atmosphere at home, making a point to enjoy other activities with your partner, and counseling.
Tamoxifen (used to prevent breast cancer) and raloxifene (used to prevent osteoporosis) are drugs known as "designer estrogens." These drugs have been developed to act beneficially as estrogen on some tissue and to act as estrogen-blockers (anti-estrogens) on other tissue. These drugs also are known by the more technical name Selective Estrogen Receptor Modulators or SERMs.
help to protect your bones
lower levels of bad cholesterol; and
may lower the risk of breast cancer.
Tamoxifen, however, acts like an estrogen on the uterus, increasing the risk of uterine cancer. Raloxifene blocks the harmful effects of estrogen on the breast and does not stimulate the lining uterus, so women who still have a uterus may want to try raloxifene.