Antidepressants And Other Medications
Antidepressant medications: The class of drugs known as selective serotonin reuptake inhibitors and related medications has been shown to be effective in controlling the symptoms of hot flashes in up to 60% of women. Specifically, venlafaxine , a drug-related to the SSRIs, and the paroxetine , desvenlafaxine , citalopram , and escitalopram have all been shown to decrease the severity of hot flashes in some women. However, antidepressant medications may be associated with side effects, including or sexual dysfunction.
Other medications: Other prescription medications have been shown to provide some relief for hot flashes, although their specific purpose is not the treatment of hot flashes. All of these may have side effects, and their use should be discussed with and monitored by a doctor. Some of these medications that have been shown to help relieve hot flashes include the antiseizure drug gabapentin and clonidine , a drug used to treat high blood pressure.
What Are The Signs And Symptoms Of Menopause
Menopause occurs when the bodys sex hormones change, and this occurs naturally as you age.
Your ovaries reduce the amount of oestrogen produced and will stop releasing an egg each month.
In the UK, the average age for a woman to go through menopause is 51.
Around one in 100 women experience menopause before the age of 40, and this is known as premature ovarian insufficiency or premature menopause.
There is no clear cause as to why early menopause happens before the age of 45.
Sometimes it can be triggered by surgeries such as some breast cancer treatments or when the ovaries are removed, or even from medical conditions such as Downs syndrome.
The severity of menopausal symptoms can vary depending on the individual. They can range from mild to significantly interrupting your daily routine.
Menopausal symptoms can start months or years before your periods stop, and can last until four years or longer after your last period.
- Vaginal dryness or discomfort during sex
- Reduced libido
- Problems with concentration or memory
If your menopausal symptoms are causing you discomfort or occur before the age of 45, your GP may be able to help.
Not only has going through menopause impacted her life dramatically, but it has also been monumental on her parents.
She said: Obviously they wanted grandchildren. My mum was especially disappointed.
It really frustrates me… inside you’re thinking, Why, why me? and really just want to know why, why it’s happened.
Common Diet Hailed As Worlds Best May Harm Your Fertility Experts Warn
Thrown into premature menopause, Gallagher, 16, suffered an auto-immune disease in which antibodies attacked her ovaries. Doctors say she has lost more than half her egg follicles over the past few months.
In a bid to salvage the precious cells, a top Manhattan fertility specialist performed an urgent surgery Thursday in a childrens wing of Westchester Medical Center.
Dr. Kutluk Oktay removed two-thirds of the outer layer of Gallaghers right ovary, where microscopic eggs are stored. The tissue will be cut into pieces and frozen until shes an adult and ready to become a mom and then transplanted back.
Ive always loved kids. I definitely want to have kids when Im older, said Gallagher, who lives in Pompton Plains, NJ. A high-school junior, she plans to become a nurse or child psychologist.
While ovarian tissue is frozen for women with cancer before they undergo chemotherapy, Gallaghers surgery is a first for anyone in the midst of autoimmune ovarian failure, Oktay said.
Normally, young women are diagnosed with the disease after all their eggs have been destroyed.
You never catch it when its happening because it happens really fast in a matter of months, said Oktay, who is also a New York Medical College professor and pioneered ovary-freezing and transplantation.
We were lucky to catch Stephanie at this stage, he said.
Of four patients who had ovarian tissue replaced and wanted to get pregnant, three had babies, and two are trying, he said.
Oral Contraceptives And Vaginal Treatments
Oral contraceptive pills
Oral contraceptive pills are another form of hormone therapy often prescribed for women in perimenopause to treat irregular vaginal bleeding. Women in the menopausal transition tend to have considerable breakthrough bleeding when given estrogen therapy. Therefore, oral contraceptives are often given to women in the menopause transition to regulate menstrual periods, relieve hot flashes, as well as to provide contraception. They are not recommended for women who have already reached menopause, because the dose of estrogen is higher than that needed to control hot flashes and other symptoms. The contraindications for oral contraceptives in women going through the menopause transition are the same as those for premenopausal women.
Local hormone and non-hormone treatments
There are also local hormonal treatments for the symptoms of vaginal estrogen deficiency. Local treatments include the vaginal estrogen ring , vaginal estrogen cream, or vaginal estrogen tablets. Local and oral estrogen treatments are sometimes combined for this purpose.
Vaginal moisturizing agents such as creams or lotions as well as the use of lubricants during intercourse are non-hormonal options for managing the discomfort of vaginal dryness.
Will Being Super Healthy Help Delay Menopause
Although maintaining good overall health is important for a variety of reasons, it wont necessarily translate to later menopause, says Streicher. I have women who tell me, I have a healthy diet, Im thin, I work out all the time, and I look young. Im sure Im not going to go through menopause early, and when I do, I wont have hot flashes and other symptoms. I wish I could say that was true, but its not, she says.
Body weight might matter, though. We do know that the extremes of weight, in someone who is very obese or someone with very low body weight, may impact the onset of menopause, but for the majority of women in the middle it doesnt seem to have a big impact, says Streicher.
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Treatments For Menopausal Symptoms
Your GP can offer treatments and suggest lifestyle changes if you have severe menopausal symptoms that interfere with your day-to-day life.
- hormone replacement therapy tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen
- vaginal oestrogen creams, lubricants or moisturisers for vaginal dryness
- cognitive behavioural therapy a type of talking therapy that can help with low mood and anxiety
- eating a healthy, balanced diet and exercising regularly maintaining a healthy weight and staying fit and strong can improve some menopausal symptoms
Your GP may refer you to a menopause specialist if your symptoms do not improve after trying treatment or if you’re unable to take HRT.
How Long Will Menopausal Transition Symptoms Last
Menopause is technically one full year without bleeding, and perimenopause is the stage before the final menstrual period, also known as the menopausal transition. Puberty and perimenopause are similar in that they both involve hormonal changes, and the transitions can take place over several years. Some medical organizations, such as the American Osteopathic Association, refer to perimenopause as reverse puberty in women.
According to NAMS, this phase can last four to eight years, and it comes with symptoms caused by hormone fluctuations, such as mood swings, poor sleep, and hot flashes.
The age at which a woman begins perimenopause can help predict how long the transition to menopause will last, according to research published in the journal Menopause in February 2017. The authors found that perimenopause lasted longer in women who started the transition at a younger age, and the women had more symptoms, such as hot flashes.
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What Is The Difference Between Early And Premature Menopause
Early or premature menopause happens when ovaries stop making hormones and periods stop at a younger age than usual . This can happen naturally or for a medical reason, such as when both ovaries are removed in a hysterectomy.
Early and premature menopause can have the same causes. The only difference is the age at which it happens. Menopause that happens before age 45 is called early menopause. Menopause that happens before age 40 is called premature menopause.
Women who have gone through early or premature menopause cannot get pregnant.
Diagnosis Of Primary Ovarian Insufficiency
If you have irregular periods or have stopped your periods for more than three months, please see your doctor and make sure your doctor includes hormone tests to exclude early menopause.
Your doctor will need to do a full physical examination and investigate the cause of your symptoms.
The criteria for a diagnosis of POI are:
- at least three months without a period
- two blood tests to confirm whether the levels of follicle-stimulating hormone are more than 40IU/l the two tests need to be performed on the third day of your period and at least one month apart.
A doctor is likely to perform the following tests:
- pregnancy test, FSH and Oestradiol
- prolactin this is the hormone usually involved with breastfeeding, but when raised, it causes periods to stop
- transvaginal ultrasound this is an internal ultrasound of the vagina and uterus to check for evidence the ovary is functioning by:
- counting the number and size of the follicles or eggs in the ovary
- measuring the volume of the ovaries
- assessing the thickness of the lining of the uterus or endometrium
- checking for any blockage that is stopping menstrual blood flow.
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What Are The Symptoms Of Premature Menopause
Symptoms of premature menopause are often the same as those experienced by women undergoing natural menopause and may include:
- Irregular or missed periods
- Periods that are heavier or lighter than usual
- Hot flashes
These symptoms are a sign that the ovaries are producing less estrogen.
Along with the above symptoms, some women may experience:
- You have undergone chemotherapy or radiation
- You or a family member has an autoimmune disorder such as hypothyroidism, Graves’ disease, or lupus
- You have unsuccessfully tried to become pregnant for more than a year
- Your mother or sister experienced premature menopause
Menopause Can Have Mental And Emotional Effects Too
Most people dont like their period, but when it goes away you feel your age, Dr. Rowen tells SELF. For some people, the idea of losing their period can be psychologically distressing.And as we mentioned, your hormones, specifically estrogen and progesterone, change during menopause. And this change may cause feelings of anxiety and depression. Lower estrogen can also trigger hot flashes that make it difficult to sleep, leading to mood swings and anxiety. Coupled with any emotional distress from losing your period, and you understandably may not be in the mood to have sex. If you feel down for more than two weeks, you may be depressed and want to speak with a therapist, the Cleveland Clinic recommends. However, finding a therapist can be a long, and often stressful, process. . Generally, you will want to start by asking your insurance company for a list of providers. If you dont have insurance, websites like Open Path include therapists who offer reduced-fee sessions.
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What Other Medications Treat Menopause Symptoms
The classes of drugs known as selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors , typically used in the treatment of depression and anxiety, have been shown to be effective in reducing menopausal hot flashes. Paroxetine is an SSRI that has been approved for the treatment of moderate to severe hot flashes associated with menopause. Another SSRI that has been tested and shown to be effective is venlafaxine , although other SSRI drugs may be effective as well.
Progestin drugs have also been successfully used to treat hot flashes. Megestrol acetate is sometimes prescribed over the short term to help relieve hot flashes. Serious effects can occur if the medication is abruptly discontinued, and megestrol is not usually recommended as a first-line drug to treat hot flashes. An unpleasant side effect of Megestrol is that it may lead to weight gain.
Several medications may be used for preventing and treating osteoporosis.
What Is Hormone Replacement Therapy
Hormone replacement therapy is a treatment for menopause symptoms. It involves taking synthetic hormones . HRT can involve taking estrogen alone or estrogen combined with another hormone, progestin. Some people have found that HRT can relieve menopause symptoms. These symptoms include hot flashes, vaginal dryness, and some urinary problems. However, HRT is not for everyone. Recent studies suggest that for most people, the risks of using HRT may outweigh the benefits. Talk to your doctor about the risks and benefits of HRT.
The American Academy of Family Physicians recommends against the use of combined estrogen and progestin for the prevention of chronic conditions in postmenopausal women. The AAFP also recommends against the use of estrogen for the prevention of chronic conditions in postmenopausal women who have had a hysterectomy.
According to the AAFP, This recommendation applies to postmenopausal women who are considering hormone replacement therapy for the primary prevention of chronic medical conditions. It does not apply to women who are considering hormone therapy for the management of menopausal symptoms, or to women who have had premature menopause , or surgical menopause.
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Your Libido Might Dip Thanks To Menopause
Its not universal, but some people with menopause report decreased libido, says Dr. Pizarro. Issue is, it’s tough for doctors to figure out how to combat a lowered sex drivethe cause isnt exactly easy to pinpoint. For decades, weve blamed loss of libido on a womans ovaries or hormones, says Libido is such a complicated thing that goes way beyond issues of the ovaries, uterus, and hormones, says Dr. Pizarro.
Beyond whatever mysterious physiological changes might affect someones libido at this life stage, adjusting to menopause’s physical changes might play a role. Adequate exercise helps make sure your blood is flowing properly, which is an essential part of getting wet during sex.
Removal Of The Ovaries
If you have surgery to remove your ovaries , you will experience menopause immediately because the organs that produce hormones and release eggs are no longer present.
Menopause that occurs from the absence of ovaries is known as surgical menopause.
Conditions like endometriosis, tumors, and cancer may require a person to have their ovaries removed.
People who have an oophorectomy will experience typical menopause symptoms however, rather than having them come on gradually as they would with natural menopause, they will experience them all at once, which can be intense.
Hormone replacement therapies can be used to treat menopause symptoms. However, hormone therapy is not recommended for people being treated for breast cancer, as it may increase the risk of recurrence.
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Trouble Focusing And Learning
In the lead-up to menopause two-thirds of women may have difficulty with concentration and memory.
Keeping physically and mentally active, following a healthful diet, and maintaining an active social life can help with these issues. For example, some people benefit from finding a new hobby or joining a club or a local activity.
Symptoms Of Premature And Early Menopause
The symptoms of early menopause are the same as for menopause at the typical age and can include:
- menstrual cycle changes, including changes to the usual bleeding pattern, particularly irregular bleeding
- hot flushes
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Addressing Sexual Problems Caused By Premature Menopause
A woman’s enjoyment of sex — even her sex drive — may also take a swan dive if she’s in early menopause, Shapiro says. Vaginal dryness occurs when the body’s estrogen levels are low, which can lead to painful intercourse. “Vaginal estrogen tablets work well,” he says, as does vaginal cream. “These don’t get into the body, only into the vagina.”
Women without working ovaries also suffer lower testosterone, the male hormone that women have in small amounts. Thereâs been a lot of attention in the media about testosteroneâs ability to boost libido in women as well as in men. But Shapiro says he doesnât think the evidence justifies testosterone treatment for most women. “There are so many factors in a woman’s sex drive,” he tells WebMD. “No one has ever shown that libido is solely related to male hormones.”
Hormone therapy can be a valuable tool in treating symptoms of premature menopause, says Shapiro. “We can re-establish normal menstrual cycles, implant fertilized eggs. It’s like there’s no difference.”
Talk to your doctor, says Shapiro. “We believe in giving patients the information they need — like whether to have ovaries removed or not. Don’t make that decision based on age alone. Discuss it with your doctor. Talk about your priorities. Make your decision based on information, not on what you’ve heard from a friend.”
Symptoms Of The Menopause
Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.
Common symptoms include:
- reduced sex drive
- problems with memory and concentration
Menopausal symptoms can begin months or even years before your periods stop and last around 4 years after your last period, although some women experience them for much longer.
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