During the peri-menopausal time (the time that leads up to a woman’s last period), her oestrogen/estrogen and progesterone levels fall. This fall in hormone levels gives the symptoms we associate with this time.
There are a lot of different treatments for these symptoms and we’re going to look at the prescription meds here.
If you’re interested in herbal, natural and alternative peri-menopause treatments, then look at this article.
Does the menopause need treatment?
No, it doesn’t, unless the symptoms bother you.
The menopause is a naturally occurring time in a woman’s life and many have no problems or symptoms that they want to treat.
But many women do have troubling effects of the menopause that impact on their everyday lives.
If you are in the second group then don’t feel you have to put up with it, or that it’s a sign of weakness if you ask for help because your mother soldiered on through her symptoms.
How do I decide on treatments for the menopause?
Medical treatments for the menopause will focus on the symptoms that are of most concern to the woman herself.
- There are symptoms that are troublesome such as hot flashes, vaginal dryness and mood changes that are often helped with hormone replacements.
- And there are consequences of the decrease in the hormones that can give other troubling problems such as cardiovascular disease (heart attack and stroke) and bone loss (osteoporosis). These are treated with different drugs.
So make a point of talking honestly with your doctor. He/she will want to take a full medical history and discuss your family history. This tells him/her what risks factors you have for certain diseases, such as heart disease, stroke and cancers, all of which can occur because of the menopause and/or its treatments.
Your doctor will also give you a physical exam and make sure you’re up to date with your cervical and/or breast screening if these are relevant.
Hormone treatments for the menopause.
For hot flashes, sweats, mood problems and sleeping problems, hormone replacement therapy (HRT) – now called Menopause Hormone Therapy (MHT) can bring relief. MHT works well for even moderate to severe peri-menopause symptoms and can also slow bone loss.
MHT involves taking hormones to replace what is lost during the peri-menopause. These hormones are oestrogen/estrogen and progesterone. Women who have had their uterus removed will just take progesterone.
These hormones come in different strengths of tablets, patches, pessaries (vaginal ‘pills’), rings and gels.
You may need to try a few different forms and doses, and different brands before you settle on one that suits you best.
HRT doesn’t suit everyone and there are risks associated with it. For some women it can increase their chances of developing:
- Cardiovascular problems – heart attack and stroke
- Blood clots in the legs and lungs
- Breast cancer
- Gall bladder problems.
Low doses of the MHT may be better for some women and research into this area is always developing.
Not all women can take MHT and it is not recommended for women with a history of:
- Undiagnosed vaginal bleeding
- Breast cancer
- Womb (uterine) cancer
- Stroke or heart attack
- Liver disease
- Blood clots in the legs or lungs
- Or those who might be pregnant.
If you start or are taking MHT (menopause hormone therapy) and have any of the following symptoms, you should discuss them with your doctor:
- Vaginal bleeding
- Bleeding after sex
- Feeling bloated
- Tenderness in the breasts or breast swelling
- Mood changes.
These can be side effects of MHT and can mean that you need to try another dose or brand, or that you need to stop taking it.
Other treatments for menopausal problems.
1. Heart disease and stroke (cardiovascular disease).
During a woman’s pre-menopausal life, her oestrogens protect her from some of the harmful effects of cholesterol. As the oestrogen decreases her risk of heart attack and stroke increases as this protective effect is lost.
Therefore cholesterol lowering meds may be needed, especially if the cholesterol level is raised and/or there is a family history of heart problems or stroke.
Your doctor will also want to check your blood pressure and counsel you about smoking if that’s relevant, as these are also major contributors to cardiovascular disease.
2. Bone loss (osteoporosis).
We think of bone as just being ‘there’, not doing much other than holding us upright. In fact it’s a living tissue like any other organ. It is continually being lost and replaced by the body, so that it keeps its strength.
However as we grow older, and as women lose their oestrogen/estrogen, the rate of bone loss can over take the rate of replacement. This means that the bones get gradually weaker – a condition called osteoporosis – and prone to breaking.
It often runs in families so tell your doctor if other women in your family have suffered with bone fractures as they got older.
There are meds designed to slow the rate of bone loss and in some cases re-strengthen the bones. MHT can also have a beneficial effect on bone loss.
Your doctor will be able to advise you as to whether you need these meds and you may need a bone scan to determine if they are already looking weaker than they should for your age.