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As the classic symptoms of perimenopause begin to manifest themselves i.e. menstrual periods that occur at irregular intervals, heavier menstrual
periods or even lighter and more infrequent periods, emotional changes and mood swings, anxiety, depression, sleep disturbances, concentration and
memory problems due to sleep loss, headaches, heart palpitations and a general itching, there are medication options which will help the body to
transition more smoothly to the state of menopause it is seeking.
One of the first steps is to contact your primary health care provider and get a full check-up along with a diagnosis of you menopausal state.
Once you have a handle on the symptoms you are experiencing (it could be all of them but often it is just a few such as hot flashes and insomnia)
your doctor and yourself can then decide on a strategic approach to dealing with the symptoms and your whole body health. While it may seem important
to treat just the symptoms it might be a good idea to treat the source of these problems, although this can often take more time and diagnostic effort
along with a more intense personal regimen.
Estrogen Replacement Therapy
The first therapeutic course sought for alleviation of the effects of menopause is estrogen replacement therapy. Estrogen replacement therapy helps replace,
at a significantly lower rate, the lower levels of estrogen secreted by the ovaries as the body moves towards menopause. Your family and medical history are
going to be major considerations as to whether you will be a candidate for hormone/estrogen replacement therapy. Since each person is unique, these and other
factors will need to be considered before you and your primary healthcare provider can make a decision as to which of the many hormone replacement therapies
to pursue. Recent studies on replacement therapies suggest that there are significant risks for long term hormone replacement and estrogen replacement
therapies which may outweigh the benefits these treatments provide for many women. So once again, it is important to discuss these options with a trusted
healthcare provider.
- Conjugated Equine Estrogens (Premarin, Premarin Vaginal Cream)
- Synthetic Conjugated Estrogens (Cenestin)
- Esterified Estrogens (Estratab, Menest)
- Estropipate (Ortho-Est, Ogen, Ogen Vaginal Cream)
- Micronized 17-beta estradiol (Estrace, Matrix patch: Alora, Climara, Esclim, Vivelle, Vivelle-Dot;
- Reservoir Patch, Estraderm, Estrace Vaginal Cream, Estring Vaginal Ring)
- Estradiol Hemihydrate (Vagifem Vaginal Tablet)
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Estrogen replacement therapy will only replace a small amount of the hormone your ovaries have been producing. In general these therapy medications
will help to reduce the symptoms and side effects produced by your body’s changing chemical balance. They often help reduce vaginal dryness, hot
flashes and the risk of osteoporosis. Recent studies show that certain hormonal cancers, heart disease and other risk factors should disqualify people
suffering from these conditions for estrogen replacement therapy. Clear evidence points to the increased risk of developing heart disease, endometrial
cancer, ovarian and breast cancers, blood clots, and stroke. Furthermore there may also be some possible side effects.
Progesterone
Furthermore it is important, if you decide to embark on hormone replacement therapy, to combine progestogen with estrogen replacement. The body will
need a substitute for the progesterone it once produced to reduce the risk of uterine cancer. If the candidate has had a hysterectomy then there is no
risk of uterine cancer.
- Medroxyprogesterone acetate (Amen, Cycrin, Provera)
- Norethindrone (Micronor, Nor-QD)
- Norethindrone acetate (Aygestin), Norgestrel (Ovrette)
- Levonorgestrel (Norplant)
- Megestrol Acetate (Megace)
- Medroxyprogesterone acetate (Depro-Provera)
- Levonorgestrel (Mirena)
- Progesterone USP (Prometrium)
- Progesterone (Crinone)
- Progesterone (Progestasert)
Side effects for these medications include headaches, mood swings, fluid retention and weight gain.
Hormone Replacement Therapy
The combination of estrogen and progesterone is called hormone replacement therapy and there are many medications available for those wishing to
take the two in combinative form. But once again there is an increased risk for stroke, cancer and heart attack.
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- Conjugated Equine Estrogens and Medroxyprogesterone Acetate (Premphase)
- Oral, Continuous-Combined: Conjugated Equine Estrogens and Medroxyprogesterone Acetate (Prempro), Ethinyl Estradiol
and Norethindrone Acetate (Femhrt), 17-Beta Estradiol and Norethindrone Acetate (Activella)
- Oral, Intermittent-Combined: 17-Beta Estradiol and Norgestimate (Ortho-Prefest)
- Skin Patch, Continuous Cycle: 17-Beta-Estradiol and Norethindrone Acetate (CombiPatch)
- Skin Patch, Continuous Combined: 17-Beta-Estradiol and Norethindrone Acetate (CombiPatch).
Other Medications
One of the possible side effects of menopause is a loss of sex drive. Women produce androgen (a predominantly male hormone) which contributes
to their sex drive. If you notice a significant decrease in this area it may be wise to consider taking androgen which must be taken in concert
with estrogen. Furthermore, as osteoporosis begins to become a factor, a woman may wish to consider taking bisphosphonates. This may help to reduce
bone loss and prevent fractures. Selective estrogen receptor modulators are an alternative that provide the beneficial effects of estrogen without
the risk of breast cancer or uterine bleeding. These medications have an increased risk for blood clots, hot flashes and gallstones.
A woman should also consider the wide array and variety of natural, herbal and holistic treatments available for reducing the symptoms and effects
of both menopause and the treatment and replacement therapies. The important thing to remember is that the body is seeking balance. An approach
towards encouraging the body towards that state will most likely be beneficial. Also it’s important to learn to maintain a sense of peace
and well being. A good meditation routine will help in this area. Finally remember there are others going through the same things you are experiencing.
Connect with a small group, a good friend or a mentor. All women have gone, will go, or are going through this. So don’t choose to go it alone,
make the choice to deal proactively with the next phase of your life.
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