Menopause
Alternate Names : Perimenopause, Postmenopause
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Menopause Treatment
Menopause is a natural process. It does not necessarily require treatment unless menopausal symptoms, such as hot flashes or vaginal dryness, are particularly bothersome.
Often one big decision you may face is whether to take hormones to relieve your symptoms or not. It is important to discuss this thoroughly with your doctor, weighing your indivdual risks against any possible benefits. Pay careful attention to the many options currently available to you that do not involve taking hormones.
If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary.
HORMONE REPLACEMENT THERAPY
For years, hormone replacement therapy (HRT) was the main treatment for menopause symptoms. Many physicians believed that HRT was not only the best treatment available for reducing menopausal symptoms, but also reduced the risk of heart disease and bone fractures from osteoporosis (thinning of the bones). However, the results of a major study -- called the Women's Health Initiative (WHI) -- has led physicians to revise their recommendations regarding HRT.
In fact, one part of this important study was stopped early because the health risks outweighed the health benefits for women taking both estrogen and progesterone. Women taking both of these hormones did see benefit as far as their bones were concerned. However, they greatly increased their risk for breast cancer, heart attacks, strokes, and blood clots.
If your symptoms are severe, you may still want to consider HRT for short-term use (two to four years) to reduce vaginal dryness, hot flashes, and other symptoms.
To reduce the risks of estrogen replacement therapy and still gain the benefits of the treatment, your doctor may recommend:
- Using estrogen/progesterone regimens that do not contain the form of progesterone used in this arm of the study.
- Using a lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream rather than a pill).
- Having frequent and regular pelvic exams and Pap smears to detect problems as early as possible.
- Having frequent and regular physical exams, including breast exams and mammograms.
ALTERNATIVES TO HRT
The good news is that there are lots of things that you can do to reduce your menopausal symptoms without taking hormones. These include:
- Dressing lightly and in layers.
- Avoiding caffeine, alcohol, and spicy foods.
- Practicing slow, deep breathing whenever a hot flash starts to come on. (Try taking 6 breaths per minute.)
- Seeing an acupuncturist.
- Using relaxation techniques like yoga, tai chi, or meditation.
- Eating soy foods.
- Remaining sexually active to preserve elasticity of your vagina.
- Performing Kegel exercises daily to strengthen the muscles of your vagina and pelvis.
- Using water-based lubricants during sexual intercourse.
There are also some medications available to help with mood swings, hot flashes and other symptoms. These include low doses of antidepressants such as paroxetine (Paxil), venlafaxine (Effexor) and fluoxetine (Prozac), or clonidine, which normally used to control high blood pressure.
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