A CAPSULAR MOMENT 

ESTROGEN AND MENOPAUSE

By David Bodunde

Menopause is the permanent cessation of menstrual periods that occurs naturally or as a result of chemotherapy, surgery, or radiotherapy. Natural menopause is confirmed after a woman has not had menses for 12 consecutive months and after other pathologic or physiologic causes are ruled out.

Common symptoms of menopause include hot flashes, night sweats, and vaginal dryness and sleep disturbances. Other symptoms often attributed to menopause, but not necessarily well supported by data, include mood symptoms, cognitive disturbances, urinary incontinence, uterine bleeding, and sexual dysfunction. A new complaint suffered by post menopausal women is whiplash caused by the back-and –forth advice from the so called medical experts.

Results from observational studies in the 1980s and 1990s suggested that hormone therapy was protective against coronary heart disease and related mortality, thus contributing to an increase of women being prescribed hormones. In 2002 a large trial had to be stopped because the trial which compared women over 50 who took hormones with women who did not, found that there was an increased incidence of breast cancer in the group that took hormones. This resulted in a drop in the number of women taking hormones. In 2007-2009 a follow up trial concluded that hormones did not appear to increase heart risk but could actually lower it. So should women jump back on the hormone bandwagon?

 PROS AND CONS OF ESTROGEN USE

Estrogen therapy is the most consistently effective therapy for common menopausal symptoms, which include hot flashes, night sweats, disturbed sleep, and vaginal dryness. They are also effective in preventing osteoporosis (bone loss) that occurs after menopause as well as colon cancer. The risks of hormone therapy include increased risk of heart disease, breast cancer in women of any age, development of blood clots which can travel to the lungs and brain as well as the possibility of dementia. Other side effects include breast tenderness and irregular bleeding.

MANAGEMENT 

Lifestyle modification 

Lifestyle modification is the first step in managing menopausal symptoms. Women who are overweight are more likely to experience moderate to severe hot flashes. Cigarette smoking also increases the frequency and severity of hot flashes so it is highly recommended that postmenopausal women exercise regularly as well as embark on a healthy diet with adequate
fruits and vegetables. 

Reducing the severity of hot flashes can also be achieved by dressing in layers, preferably with natural fabrics such as cotton or silk, so that you can add or remove clothes as needed. Keep room temperatures cool. Drink cold beverages, limit caffeine and alcohol and eat smaller meals. Non petroleum lubricants like K-Y jelly and Replens can help vaginal dryness and lessen the pain during intercourse. 

To ward of osteoporosis,  increase dietary source of calcium by eating low fat dairy products, dark leafy greens, and calcium fortified orange juice, tofu and other foods that contain lots of vitamin D such as herring and salmon. Sometimes food sources may not be adequate and supplements of calcium and vitamin D can be used. 

Conventional medicines

Like estrogens may be the medication of choice, but it is always advisable to to use the lowest possible dose for the shortest period of time necessary. There are different estrogen products ranging from pills to vaginal creams, skin patches and sprays. Your doctor should help you make a decision on what product is best for you.

Off-label conventional medicines

Are also used as alternatives to hormonal treatments. Anti-depressant drugs like Venlafaxine, blood pressure pills like clonidine as well as methyldopa are being prescribed for the treatment of hot flashes, but none of these treatments seem to be as effective as estrogen for hot flashes.

Natural medicines

That are used for treating common menopausal symptoms include soy, DHEA, flaxseed, black cohosh, chasteberry, kudzu, alfalfa, licorice, evening primrose, panax ginseng, wild yam or vitamin E. The product with the most evidence of effectiveness is soy. Soy protein containing foods are preferred over soy extract supplements. There is less known about the long term safety of soy extract supplements. 

To speak with David Bodunde, Rph in person, visit the  Manitouwadge Pharmacy, Unit 2, Hallmarket Square
in Manitouwadge or call 826.3888

The opinions expressed on OntarioNewsNorth.com and by David Bodunde,Rph  are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis and treatment. Please consult a local physician or other health care professional for your
specific health care and/or medical needs or concerns.

Neither OntarioNewsNorth.com nor David Bodunde,Rph  endorse or recommend any commercial products, medical treatments, pharmaceuticals, brand names, processes, or services, or the use of any trade, firm, or corporation name is for the information and education of the viewing public, and the mention of any of the above on OntarioNewsNorth.com does not constitute an endorsement, recommendation, or favoring by OntarioNewsNorth.com or David Bodunde, Rph.