Management of Post Menopause symptoms
Menopause is the general term that is used to refer to the entire process of pre-menopause through post-menopause. The average age of menopause is about 51 years. In the sense of distinguishing the different stages of menopause such terms will be used in this course:
· Pre-menopause – that reproductive or fertile stage, from menarche to the last menstrual period.
· Peri-menopause – the years immediately before menopause which is about four to ten years or until menstruation have stopped for a year. In this stage, hormone fluctuations occur and menstrual period becomes erratic, estrogen levels maybe higher which triggers PMS symptoms or estrogen may become lower so symptoms like hot flashes, vaginal dryness, and mood swings are experienced.
· Menopause – Technically, is the date of the last period. This can be confirmed if period is missed for 12 consecutive months without any other obvious causes.
· Post-menopause – It begins after the final menstrual period and lasts for lifetime. The symptoms associated with hormonal imbalances are no longer felt but the risk of osteoporosis and heart diseases are increased.
Signs and Symptoms of menopause:
1. Period changes- May be shorter or longer, lighter or heavier and the interval between period may increase or decrease.
2. Irregular vaginal bleeding or breakthrough bleeding
3. Hot flashes and night sweats. A hot flash is a feeling of warmth and flushes that concentrates in the chest and face that usually lasts 30 seconds to 10 minutes.
4. Vaginal symptoms –As estrogen levels fall, the lining tissue of the vagina becomes thinner, dry and less elastic resulting to itching and dryness, irritation and dyspareunia or having pain during sexual intercourse.
5. The lining of the urethra also becomes thinner, drier and less elastic resulting more urinary tract infections and vaginal infections and urinary incontinence.
6. Fatigue, memory problems, irritability and rapid changes of mood.
7. Weight gain and fat accumulation in the middle or the stomach area
8. Adult acne
9. Wrinkles
10. Hirsutism
11. Loss of androgen like testosterone resulting to lowered sex drive
Hormone Therapy (HT)
Also known as HRT (hormone replacement therapy) or PHT (Post menopausal hormone therapy), exists 2 types:
a) Estrogen therapy – this is prescribed to women who have undergone hysterectomy due to its higher risk of causing endometrial or uterine cancer
b) Estrogen-Progestin therapy – A combination of estrogen and progesterone, is for women who have intact uterus. Progesterone, though, may increase the risk of heart attack and breast cancer.
HT is available in oral pill form, transdermal patch and/or spray, creams or gels.
Newer form of HT called Bioidentical hormone therapy are medications that contain hormones with the same chemical formula as those naturally formed in the body. These are formulated in the laboratories by altering thecompounds derived from naturally-occurring plant products. These are available in gel and cream forms.
Side effects of HT:
Minor: Headache, nausea, breast pain.
Serious effects: DVT, blood clot, pulmonary embolism, heart disease, abnormal vaginal bleeding and stroke.
Antidepressant medications
SSRIs also help control the symptoms of hot flashes like Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Desvenlafaxine (Pristiq) and Citalopram. Other related medications are also effective like Venlafaxine (Effexor). Side effects include decrease libido and sexual dysfunction.
Blood pressure medication like Clonidine – can help ease the flashes
Alternative Therapies
Plant estrogens/ Phytoestrogens/Isoflavones: Found in soy and other phytoestrogen plants like Red Clover. Their chemical structure is similar to natural estrogens but is less potent.
Others: Black Cohosh, Licorice, Dong Quai, Chasteberry, Wild
Natrol Promensil menopause contain isoflavones Red clover with calcium. Dosage is 1 tablet per day.
July 2019
Sara Silva
- Course creator: Lurdes Pastor
- Course creator: Eliana Sequeira
- Course creator: Molly WONG