By Richard N. Waldman, MD
President, The American Congress of Obstetricians and Gynecologists
Hot flashes, night sweats, mood swings, and vaginal dryness are notorious symptoms associated with menopause—the time in a woman’s life when her ovaries stop producing eggs and menstrual periods cease. An estimated 6,000 women in the US reach menopause each day, and most of them will experience symptoms to some degree.
Simple lifestyle changes can help reduce menopause symptoms and lower the risk of disease in the future. Consume a healthy, calcium-rich diet that includes plenty of fruits, vegetables, and grains. Exercise regularly to improve mood, slow bone loss, and fight the mid-section weight gain that increases the risk of heart disease. Avoid common hot flash triggers such as alcohol, caffeine, hot beverages, and spicy food. Quit smoking. Dress in layers so you can quickly cool down when you feel a hot flash coming on. If vaginal dryness is a problem, try an over-the-counter lubricant cream or gel to restore moisture, especially before sex.
If your symptoms are intense enough to interfere with your quality of life, talk to your doctor. Hormone therapy (HT), which replaces the hormones no longer made by the ovaries with synthetic hormones, is an effective treatment for some women. Antidepressants may be prescribed to help with mood, hot flashes, and vaginal dryness.
Because certain types of HT have been linked with an increased risk of health problems—such as blood clot, stroke, heart attack, and breast cancer—HT is not the best choice for everyone. Women who should not take HT include those who have had some types of abnormal bleeding, blood clots, heart attack, or stroke; most women with an estrogen-dependent cancer; and women with liver disease or dysfunction. Breast cancer survivors should consider an alternative to HT treat symptoms. Women who are good candidates for HT should take the lowest dose necessary to relieve symptoms for as short a time as possible.
Compounded menopausal hormone therapy (or so-called “bioidentical” hormones) are plant-derived hormones, hand-mixed by a pharmacist and marketed for the treatment of menopausal symptoms. The manufacturers of certain compounded hormones claim that their products offer relief from menopausal symptoms as well as prevention or treatment for serious diseases. However, the US Food and Drug Administration has stated that these claims are false, misleading, and a violation of federal law. Neither com-pounded nor herbal supplements, such as black cohosh and soy, are regulated by the FDA. Using substances that have not been tested for safety can result in negative health consequences.
For more information, visit pause.acog.org, the website devoted to menopausal and midlife health. ?
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