10 Treatment Options for Menopause

More than 50 million women in the United States will are over the age of 51, the average age that menopause occurs. Yet in some ways, menopause is the last taboo subject among women, many of whom are hesitant to talk about hot flashes, hormone imbalances, and a type of thinning hair that’s different from that of women in their 20s and 30s. But times are changing.

Menopause is defined as having gone 12 months without a menstrual period. The years leading up to that time may include irregular periods which may or may not be quite heavy, moodiness, fatigue, and weight gain. Most of these changes occur because of changes to the body’s production of both estrogen and progesterone, both of which are produced by the ovaries. In addition, many begin to suffer with urinary incontinence, which, while being common, is not a normal part of aging.

Fortunately, there are a multitude of effective treatment options that are both hormonal and non-hormonal. However, only about 10% of women seek medical advice during the menopausal period. Many women require no treatment, however, if symptoms are affecting a woman’s daily life she should see her doctor. The treatment options available will depend on the symptoms, medical history, and preferences of the patient.

Available treatment options include:

  1. Herbal Remedies – Soy, Black Cohosh, Relizen. These are non-estrogen compounds that while have not been specifically FDA-approved for the treatment of peri-menopausal symptoms, research studies suggest an improvement in symptoms with minimal side-effects.
  2. Paroxetine (Brisdelle) – This is the only non-hormonal FDA approved treatment for peri-menopausal symptoms.
  3. Hormone Replacement Therapy (HRT) – This is considered to be the most effective treatment to treat the above symptoms. Hormone therapy can be received by a simple patch on the skin that releases estrogen and progestin. In addition to treating many troublesome menopausal symptoms, HRT also helps to prevent osteoporosis, and lowers colorectal cancer risk. While most formulations of HRT are safe, some may raise the risk of breast, ovarian or uterine cancer, as well as raise the risk of coronary heart disease, stroke, and memory loss.
  4. Low-dose Antidepressants – Effexor, Prozac, Paxil, Celexa or Zoloft.
  5. Omega 3s – May ease psychological distress and depressive symptoms often suffered by menopausal and peri-menopausal women.
  6. Gabapentin (Neurontin) – This is effective in treating hot flashes. It is commonly used for treating seizures.
  7. Vaginal Estrogen – Vaginal estrogen may be applied locally using a tablet, ring or cream. This medication effectively treats vaginal dryness, discomfort during intercourse, as well as some urinary problems. A small amount of estrogen is released and absorbed by the vaginal tissue.
  8. Ristela – A novel herbal therapy functions to increase nitric oxide concentrations in the vagina. This leads to the increased blood supply to the vagina which results in increased libido and improved sexual function.
  9. Exercise.
  10. Hypnosis and Acupuncture – May prove effective for the treatment of hot flashes. Researchers reported in the Journal of Menopause, in October 2012, that hypnosis can reduce the symptoms of menopausal hot flashes by up to 74%.

Written by Dr. Paul Littman

Dr. Littman became the first urogynecologist to practice in Sussex, Warren, and Morris counties. He has brought a multitude of novel, minimally-invasive outpatient procedures to northwestern New Jersey including single-incision vaginal approaches to correct both urinary incontinence and pelvic organ prolapse, robotic surgery, sacral neuromodulation, botox-injections, and acupuncture-based treatments.


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