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What Do Doctors Prescribe For Menopause

Types Of Menopause Medicines

Menopause Hormone Replacement Therapy (HRT)

Hormone replacement therapy : This is the most common medical treatment for the symptoms of menopause. It works by replacing the hormone oestrogen . You can take it as a pill, patch, gel or vaginal cream or pessary. HRT is now called Menopausal Hormone Therapy .

Tibolone : This is a synthetic hormone that has a similar action to oestrogen, progesterone and testosterone. Tibolone is not linked to breast cancer in women who have never had breast cancer, but it is not recommended for women who have had breast cancer before.

Antidepressants: May be prescribed to help reduce hot flushes, especially if you dont want to or cant take MHT.

How To Treat Vaginal Dryness In Menopause

“My vagina is as dry as the Sahara desert!” was written in all block letters by a recent patient on the top of their;paperwork as their;chief complaint. I chuckled as I entered the room, but luckily was able to offer them;a variety of treatment options.

Most women know that menopause often causes women to experience their “own person summers” with hot flashes and night sweats, but another common symptom is vaginal dryness, which can mean painful and less enjoyable sex.

The vaginal walls contain an abundance of estrogen receptors. When estrogen level plummet during menopause vaginal walls that were once elastic, expandable, supple, and sturdy can, over time, become tightened and fragile. The skin can become as thin as tissue paper, unable to withstand the manipulation that occurs with sexual activity, and can tear and even bleed with intercourse.

Use it or lose it

When sex becomes painful, the natural response is to begin to avoid intercourse. But without continued sexual activity , the vagina becomes even smaller and tighter, making a bad problem even worse. Add in a partner with erectile dysfunction and its not unusual for a woman to present to me not having had sex in a year or more, wondering if theres anything that can be done to get back the sex life they once enjoyed.

Fortunately, the answer is almost always a resounding Yes!

Non-Hormonal Treatment

Vaginal moisturizers

Vaginal Lubricants

Vaginal Hormonal Treatment

Vaginal estrogen therapy

Hrt For Breast Cancer Survivors

It is advisable for women with a history of breast cancer to avoid HRT unless other treatments are ineffective, and their quality of life is made intolerable by menopausal symptoms. In these circumstances, HRT should only be prescribed in consultation with the womans breast surgeon or oncologist.

Evidence has not conclusively shown that HRT will increase the risk of breast cancer recurring in a woman with a history of the disease. However, oestrogen and progestogens may stimulate some types of cells in the breast and some types of HRT use have been associated with an increase in the risk of breast cancer in women without a history of breast cancer.

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What Is Relaxation Breathing

Deep breathing, relaxation breathing, and paced respiration all refer to a method used to reduce stress. It involves breathing in deeply and breathing out at an even pace. Do this for several minutes while in a comfortable position. You should slowly breathe in through your nose. With a hand on your stomach right below your ribs, you should first feel your stomach push your hand out, and then your chest should fill. Slowly exhale through your mouth, first letting your lungs empty and then feeling your stomach sink back. You can do this almost anywhere and several times during the day, whenever you feel stressed. You can also try this if you feel a hot flash beginning or if you need to relax before falling asleep.

Added Benefits Of Hrt

Types of Doctors Who Prescribe Hormone Replacement Therapy

HRT reduces the risk of various chronic conditions that can affect postmenopausal women, including:

  • diabetes taking HRT around the time of menopause reduces a womans risk of developing diabetes
  • osteoporosis HRT prevents further bone density loss, preserving bone integrity and reducing the risk of fractures, but it is not usually recommended as the first choice of treatment for osteoporosis, except in younger postmenopausal women
  • bowel cancer HRT slightly reduces the risk of colorectal cancer
  • cardiovascular disease HRT has been shown to reduce cardiovascular disease markers when used around the time of menopause.

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  • Menopausal symptoms can be managed with education, lifestyle changes, support and hormone replacement therapy , also known as menopausal hormone therapy .
  • In the early postmenopausal years, HRT is an effective therapy for menopausal symptoms. In most women with moderate to severe symptoms, the benefits outweigh the small increases in risk.
  • The long-term use of HRT has some benefits, but also has some risks.
  • The current role of HRT is for menopausal symptom relief, at the lowest effective dose and for the shortest duration required for the control of bothersome menopausal symptoms.
  • The decision to use HRT, and for how long it should be used, must be based on individual assessment and needs.

What Do Estrogen Pills Do

In fact, it is necessary to go back to the basics of estrogen pills. One should know that doctors do not prescribe them as the only possible solution. Usually, gynecologists insist that forehanded care of your body is key to comfortable living. Nevertheless, such a thing as a genetic or predisposition can radically disappoint you with the results. So, what are the estrogen pills benefits and functionalities?

The synthesis of estrogens in the female body usually starts during puberty. And, it may last until the onset of menopause or else called perimenopause. Estrogens are responsible for a womans youth and beauty, her emotional state and, of course, libido. Besides, estrogens are responsible for bone strength, good memory, blood cholesterol, skin condition and more. Accordingly, the use of estrogen pills for menopause will be directed on helping memory, overall health condition, and preventing any injuries.

The use of estrogen and progesterone pills for menopause helps to keep the skin and mucous membranes moist. Moreover, estrogens support the functioning and integrity of the stratum corneum.

At last, estrogen pills for menopause, acting on receptors, promote faster growth of vascular endothelial cells, help the endothelium to recover faster after damage. When estrogen is low, endothelial function is impaired. And as you know, the good blood supply is the key to beauty and youth.

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Ask Yourself The Following Questions:

  • What is the treatment?
  • What are the side effects?
  • Is it effective?
  • How much does it cost?

Once you answer these questions, discuss the therapy with your doctor. Make sure your doctor knows what therapy you are considering in order to discuss possible interactions or side effects with your current treatment.

Vaginal Dryness And Discomfort

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If;your vagina becomes dry, painful or itchy as a result of the menopause, your GP can prescribe oestrogen treatment that’s;put directly into your vagina as a pessary, cream or vaginal ring.

This can safely be used alongside HRT.

You’ll usually need to use vaginal oestrogen indefinitely, as your symptoms are likely to return when treatment stops. However, side effects are very rare.

You can also use over-the-counter vaginal moisturisers or lubricants in addition to, or instead of, vaginal oestrogen.

Read more about;vaginal dryness and sex as you get older.

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How Can Perimenopausal Women Benefit From Low

Low-dose birth control can be implemented both to prevent pregnancy and alleviate symptoms of perimenopause. Although low dose birth control is typically not recommended for individuals under the age of 30 because it can decrease bone density, it may have the opposite effect for those going through perimenopause. This is especially important, as the risk of osteoporosis increases with age. Low dose birth control may also be implemented to help prevent ovarian and uterine cancers.

Combination Estrogen And Progesterone If You Still Have A Uterus


Prempro; ; ; ; ; ; ;Climara Pro

Femhrt; ; ; ; ; ; ; ; Combipatch

Antidepressants These drugs have been approved in the last 5 years for the treatment of hot flashes. ;;Some women want another choice other than HRT and antidepressants could help.

  • Brisdelle is the only SSRI that has been approved by the FDA for hot flashes. .
  • Duavee Is an estrogen agonist/antagonist. It treats hot flashes and helps prevent postmenopausal bone loss.
  • Vaginal dryness

    VVA Vulvavaginal atrophy the lining of the vagina becomes thinner and drier. It can lead to vaginal and urinary tract problems. It can cause itching and/or burning feelings in your vagina. Vaginal atrophy is a chronic condition.; If a woman doesnt have sex regularly, her vagina may become shorter and narrower. Use it or lose it!

    Vaginal estrogen

    Estrace; ; ; ; Vagifem; ; ; ; ; ; ;Estring

    Prem VC; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; Femring

    You can also treat VVA with some HRTs, however, if youre only treating vaginal dryness, you should only use vaginal estrogen.

    Painful intercourse ; Persistent or recurrent genital pain that occurs just before, during, or after sexual intercourse.; Pain can range from moderate to severe.
  • Osphena An estrogen agonist/antagonist with tissue selective effects. It increases superficial cells and significantly reduces parabasal cells. Significantly improves moderate to severe VVA due to menopause. It is an oral tablet.
  • Premarin vaginal cream -can also be used for dyspareunia. It is a cream inserted into the vagina, usually at bedtime..
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    Hot Flushes And Night Sweats

    If you experience hot flushes and night sweats as a result of the menopause, simple measures may sometimes help, such as:

    If the flushes and sweats are frequent or severe, your GP may suggest taking HRT.

    If HRT isn’t suitable for you, or you would prefer not to have it, your GP may recommend other medicines that can help, such as clonidine ;or certain antidepressants.

    These medicines can;cause unpleasant side effects, so it’s important to discuss the risks and benefits with your doctor before starting treatment.

    Benefits And Risks Of Hormone Replacement Therapy

    When Do Doctor Prefer Hormone Replacement Therapy for ...

    The main benefit of HRT is that it can help relieve most menopausal symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.

    It can also help prevent thinning of the bones, which can lead to fractures . Osteoporosis is more common after the menopause.

    Some types of HRT can slightly increase the risk of breast cancer and blood clots in some women. You need to discuss whether you have any risk factors with a doctor or nurse.

    Evidence says that the risks of HRT are small and usually outweighed by the benefits.

    Your GP can give you more information about the risks and benefits of HRT to help you decide whether or not you want to take it.

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    Genitourinary Syndrome Of Menopause

    Genitourinary syndrome of menopause refers to bothersome genital symptoms from changes in the vulva, vagina, and lower genital tract that are caused by diminished estrogen. This condition affects up to one-half of women during menopause.28 In 2014, a consensus conference endorsed the new term genitourinary syndrome of menopause to replace the terms vulvovaginal atrophy and atrophic vaginitis, partly because the older terminology does not encompass the extent of genital tract symptoms many women experience.29 Decreased estrogen can cause several changes to genital anatomy that lead to patient discomfort. Thinning of the vulvar mucosa may cause vulvar burning, irritation, or constriction of the introitus, resulting in entry dyspareunia. Narrowing of the vagina and decreased lubrication can cause painful intercourse or coital bleeding.30 Diminished estrogen may also lead to recurrent urinary tract infections and urinary urgency.29 Genitourinary syndrome of menopause is often progressive without treatment.28

    Treatment Options for Genitourinary Syndrome of Menopause

    Estrace vaginal cream 0.01%

    Treatment Options for Genitourinary Syndrome of Menopause

    Estrace vaginal cream 0.01%

    This review updates previous articles on this topic by Hill and Hill,35 by Carroll,36 by Morelli and Naquin,37 and by Cutson and Meuleman.38

    Read the full article.

    What Are The Other Treatment Options

    If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Other treatment options include:

    • Lifestyle changes: Improving diet, regular exercise and stopping smoking improve overall wellbeing and can make symptoms easier to tolerate. Some psychological treatments e.g. cognitive behavioural therapy and mindfulness may also help
    • Menopausal Hormone Therapy : if other things do not work and you are able to have hormone treatment
    • Complementary therapies: ;

    If you have any concerns or questions about options;to manage your menopausal symptoms, visit your;doctor or go to the Find an AMS Doctor service on the;AMS website.

    NOTE: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to an individuals personal circumstances and should always be discussed with their own healthcare provider. This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members, other health professionals and their patients for clinical practice is permissible. Any other use of this information must be agreed to and approved by the Australasian Menopause Society.

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    When Should You See A Doctor About Perimenopausal Symptoms

    While experiencing some symptoms is normal and common, a person with a uterus should consult a doctor if their daily life is negatively impacted. It is possible that their experience is solely related to perimenopause, but it could also be the result of other, more serious conditions such as fibroids, pregnancy, blood clotting disorders, or even cancer. Furthermore, speaking with a doctor is necessary in order to ensure that symptoms are caused by menopause and not something else.

    The following symptoms may warrant a trip to the doctor

    • Very heavy periods with blood clots.
    • Periods that last much longer than usual.
    • Periods that occur more frequently than normal
    • Breakthrough bleeding between periods.
    • Spotting and/or pain after intercourse.

    Prescription And Nonprescription Remedies

    Understanding Menopause

    A number of non-hormonal remedies are available for the treatment of hot flashes. Some of these remedies are available over-the-counter but are not FDA-approved. Some prescription medications are used off label to help reduce hot flashes. Using a product “off label” means that it is not FDA-approved for the treatment of hot flashes, but is often used because it can be safe and effective for hot flash treatment.

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    How Can I Find A Menopause Clinic Or Specialist Near Me

    Your GP can refer you to an NHS menopause clinic, specialist doctor, or nurse practitioner. Use this British Menopause Society online search form to find out your nearest NHS menopause clinic or specialist. Waiting times can vary from weeks to months for an appointment with an NHS clinic or specialist.

    If you want to consult a menopause specialist or nurse practitioner privately, to avoid lengthy waiting times, for example, you dont need a GPs referral and you can use the same BMS online search form to find private specialists and nurse practitioners in your area.

    Contact them first to ask about referrals, appointments and, in particular, fees, as menopause treatment is not covered by private health insurance. Some private practices enable you to combine an initial private consultation with follow-up NHS treatment, so ask about that too, especially if you have a limited budget.

    Important Information About Menopause Medication

    All medicines can have side effects. For women suffering from menopause symptoms, the risks need to be weighed up against the benefits.

    However, research has shown that MHT can slightly increase the risk of developing some cancers, including breast cancer. It has also been linked to thrombosis and stroke in some women.

    If you decide to use MHT, then take the lowest dose to reduce your symptoms and regularly see your doctor to review it.

    Before taking menopause medicines, you may wish to ask your doctor about:

    • their side effects
    • what to do if you miss a dose
    • what to do if you experience side effects

    Talk to your doctor if you feel unwell when taking your medicines.

    Do not change your medicines or stop taking them without talking to your doctor.

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    Important Questions To Ask About Menopause Hormone Medicines

    • Are hormones right for me? Why?
    • What are the benefits?
    • What are the serious risks and common side effects?
    • How long should I use hormone therapy?
    • What is the lowest dose that will work for me?
    • Are there any non-hormone medicines that I can take?

    Want more information about menopause? Check the FDA website at:

    The drug and risk information in this booklet may change. Check for the latest facts on each product listed in this booklet.

    Where Can I Find Out More About Menopause And Menopause Treatment

    If your estrogen level goes down after menopause why do ...

    Youll find current NHS information on the menopause, symptoms and treatment here. In addition, these organisations offer free information on a range of menopause-related topics, including symptoms, specialists, options for menopause treatment and support, and menopause news, which could help talk to your GP about menopause and your symptoms:

    • British Menopause Society – for healthcare professionals but carries the latest news on menopause research and treatment and has an online search facility to help you find a local specialist
    • Henpicked – for women over 40, includes a section on menopause
    • Menopause Support menopause advice, information and support from Diane Danzebrink
    • Womens Health Concern – the patient arm of the BMS;

    Visit the Live Better With Menopause Community Forum for information, advice, and tips on talking to your GP – and to share your own questions and suggestions.

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