Menopause is defined as the point at which menstrual periods have stopped for 12 consecutive months. The average age of menopause, according to the North American Menopause Society, is 51.
The symptoms of menopause are naturally occurring and not signs of disease, but they can also disrupt sleep, cause weight gain and negatively affect cholesterol levels leading to osteoporosis, obesity, diabetes and cardiovascular disease. Medications are one option for managing menopausal symptoms.
Hormone Replacement Therapy
Hormone replacement therapy (HRT) for menopausal women can be accomplished with estrogen and progesterone or, for women who have had a hysterectomy, with estrogen alone.
The National Institutes of Health (NIH), the North American Menopause Society and the American College of Obstetricians and Gynecologists each have said HRT used be only for the purpose of decreasing hot flashes and other symptoms of menopause. They recommend that the smallest effective dose be prescribed for the shortest possible time with re-evaluations every six months. They also encourage women to weigh the risks of HRT against its benefits, but this requires having some background knowledge before having a discussion with a gynecologist or women's health nurse practitioner.
HRT's benefits are very specific. It reduces the number and the intensity of hot flashes by up to 80 percent, according to NIH findings. If hot flashes occur, this decrease will allow for longer and better quality sleep, with all its associated health benefits. HRT also helps prevent osteoporosis and, according to the work of Millie Long, a doctor at the University of North Carolina, published in the March 30, 2010 issue of the American Journal of Gastroendocrinology, it significantly lowers the risk of colon cancer.
But women with dense breasts before menopause will want to consider the June 2010 Report to the American Association for Cancer Research. A 24 percent higher risk of breast cancer in women who take HRT was discovered due, in large part, to their breasts remaining highly dense, a risk factor for breast cancer development. The researchers who presented this study recommend that women have mammograms to assess breast density before deciding whether or not to take HRT.
Celexa to Decrease Hot Flashes
An alternative to HRT for the relief of hot flashes is Celexa, a Selective Serotonin Re-uptake Inhibitor or SSRI antidepressant. The women in a Mayo Clinic study, published in the May-June _____edition of "Supportive Oncology," took 10 to 20 mg of Citalopram (Celaxa) each day and they averaged a 58 percent reduction in the number of their hot flashes. This is not as great a response as is seen with HRT, but it offers an alternative without the risks of estrogen therapy.
In addition, the women studied also reported "Decreased anger, tension and depression, as well as improved behavioral health improvements not associated with the use of HRT.
Nitrates and Statins
For many women, menopause's greatest threat is not drenching hot flashes or mood swings; it is the effect it has on their cholesterol profile. Menopause lowers the healthy form of cholesterol, HDL, by 4mg per deciliter while it simultaneously raises damaging LDL and triglyceride levels by 7 mg and 9 mg per deciliter respectively. These results were documented in 2007 by Dr. Norin Sultan.
Niacin is primarily prescribed for levels of HDL below 50 mg per deciliter in women; a number that should be checked before and after menopause and statins are the drug of choice for elevated LDL and triglyceride levels, according the 2009 NIH Guidelines for Cholesterol Management.
Calcium Supplementation
Menopause accelerates the loss of bone mass and bone density, which can lead to osteoporosis. To prevent this, the NIH recommends 1,500 mg of calcium each day. Though it's possible to get this quantity from salad with 2 cups of arugula, at an investment of only 100 calories, many women choose to take prescription or over-the-counter supplements to ensure a consistent intake.
Vitamin D Supplementation
To absorb calcium and transport it into the bones, the body must have an adequate supply of Vitamin D. When people walked everywhere they went, out in the sunshine, this was not a problem because the body can manufacture Vitamin D from sunlight.
The NIH recommendation for women over 50 is 400 International Units (IUs) each day. Many calcium supplements contain this amount. To obtain sufficient production from sunlight requires just 30 minutes of sunlight exposure to the hands, arms and face using a sunscreen with an SPF of 8, according to NIH guidelines.
References
- Menopause (journal); "Estrogen and progestogen use in postmenopausal women"; Dr. Wulf Hutian et al; May-June 2010
- "merican Journal of Gastroenterology; "Hormone Replacement Therapy, Oral Contraceptive Use and Distal Large Bowel Cancer"; Dr. Millie Long; March 30, 2010
- American Association of Cancer Research, 101st Annual Meeting: "HRT Increases Breast Density": April 2010
- Supportive Oncology (journal); "Evaluation of Citralopram for Hot Flash Relief"; 2003
- Ayub Medical College; "Effect of Menopause on Serum HDL"; Norin Sultan; 2007
