Menopause Management

Menopause Management

The signs and symptoms of menopause are usually enough to warn most women who have begun the menopausal transition. If you have any concerns about irregular menstrual periods or hot flashes, talk to your doctor. In some cases, they may recommend further evaluation.

Tests are usually not needed to diagnose menopause. But in some circumstances, your doctor may recommend blood tests to check blood levels.

Treatment
Menopause does not require any medical treatment. Instead, treatments focus on relieving signs and symptoms and preventing or managing chronic disorders that may occur with aging. Some of the treatments include the following:

• Hormone therapy. Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes. Based on your medical history and family history, your doctor may recommend the lowest dose of estrogen for the shortest possible period of time to relieve symptoms. If you still have a uterus, you will need progesterone in addition to estrogen. Estrogen also helps prevent decreased bone mass.
• Long-term use of hormone therapy can cause certain risks of cardiovascular disease and breast cancer, but starting to use hormones around the time menopause begins has been shown to be beneficial for some women. You and your doctor will discuss the risks and benefits of hormone therapy, and whether it is a safe option for you.
• Vaginal estrogen. To relieve vaginal dryness, estrogen can be given directly into the vagina using a vaginal cream, tablet, or ring. This treatment releases only a small amount of estrogen, which is absorbed by the vaginal tissues. This can help relieve vaginal dryness, discomfort during sex, and some urinary symptoms.
• Low-dose antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) can decrease menopausal hot flashes. An antidepressant in low doses to control hot flashes may be helpful for women who cannot take estrogen for health reasons or who need an antidepressant for a mood disorder.
• Gabapentin (Neurontin, Gralise, others). Gabapentin is approved for the treatment of seizures but has also been shown to help reduce hot flashes. This medicine is useful for women who cannot use estrogen therapy and for those who also have hot flashes at night.
• Clonidine (Catapres, Kapvay, and others). Clonidine, which comes in pills or patches and is often used to treat high blood pressure, may provide some relief from hot flashes.
• Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medications to prevent or treat osteoporosis. Several medications are available to help reduce the decrease in bone mass and the risk of fractures. Your doctor may prescribe vitamin D supplements to help build strong bones. Before deciding on any form of treatment, talk to your doctor about your options and the risks and benefits of each. Discuss your options annually, as your needs and treatment options may change.