Treatment of Menopause

Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) is the most common treatment for most symptoms of menopause, with both positive and negative effects from the treatment. Since menopause is not a disease process, but a process of natural aging, only the symptoms can be treated.  HRT is the most effective treatment for reducing the frequency and intensity of hot flashes often experienced by women in menopause.   HRT is also effective in helping to treat the menopausal symptoms of vaginal dryness and urogenital atrophy, which is a shrinking of the pelvic floor musculature which may lead to stress incontinence.  HRTs also  can help to preserve bone mass in the post-menopausal woman.  It has also been shown to reduce the occurrences of colon cancer post-menopause.  While there are numerous benefits there can be a few negative issues associated with HRT, including an increased risk for breast cancer with taking 5 or more years of continuing estrogen or progestogen therapy.   However the risk decreases after the therapy is discontinued. (No. American  Menopause Society for Reproductive Medicine,  July, 2012) Choosing the right menopause therapy requires a trip to the physician to discuss the signs and symptoms that are being experienced along with a complete physical and medical history  (Taylor & LaValleur).

Common Prescriptive Medication Treatment

Medical Interventions

Physicians and other medical practioners often will prescribe medical interventions for the menopausal women in the form of HRTs, (hormone replacement therapy). These include  transdermal patches which are worn on the abdomen and changed once or twice per week, removing the old patch and putting on a new one in a different location, or vaginal creams which are placed in the vagina with an applicator weekly, biweekly, monthly or as directed..   Oral hormone medications are also routinely prescribed…  Other medications that a menopausal woman might be prescribed depending upon her symptoms could be an antidepressant, a sleeping pill for insomnia or medication to help maintain bone mass  (Youngkin, 2005).

Many doctors also prescribe medications to help alleviate the various symptoms of menopause such as;

  • Bisphosphonates which reduce bone loss factors
  • Vaginal Esrogen Cream to relive dryness and discomfort.
  • Low doses of anti-depressants to relieve hot flashes
  • Selective Estrogen Receptor Modulators (SERM) which mirrors the same properties of estrogen for bone density disorders but without the side effects of estrogen

Complementary and Alternative Menopause Therapies (CAM)

While complementary and alternative menopause therapies can help some women, there is some question as to their actual effects. Some studies indicate there is no difference in CAM therapies compared to placebo therapy. (sugar pill)

Some of the ‘home remedies’ that women recommend include:

  • Adding foods rich in estrogenic products such as Alfalfa, soybeans, flaxseed, garlic, green beans, flax seed, cabbage and beets
  • Chamomile tea for sleeplessness
  • Essential body oils
  • Drinking a very cold glass of ice water
  • Cutting back on alcohol, tea, coffee and caffeinated sodas
  • Dressing in layers for easy on and off clothing adjustments to prepare for the body temperature changes women often experience during menopause such as hot flashes which are usually followed by feeling chilly. Some women carry a little battery operated fan in their purse or on their desk for those hot moments.

Post-menopausal Bleeding (PMB)

Post-menopausal bleeding is vaginal bleeding that occurs more than one year after the cessation of menstrual periods.  PMB may be an indicator of cervical or endometrial cancer and needs to be assessed by a gynecologist.  The gold standard for diagnosis is surgical curettage, (D&C) or hysteroscopy, in which a woman is lightly sedated and a ‘camera’ is inserted through the vagina into the uterus so the physician can see what is occurring inside the uterus, the cervix and the vagina.  Another test is the transvaginal ultrasound which is a ultrasound device which can create an image of the vagina to view on a screen. Any post-menopausal bleeding should be an indicator that a visit to a physician is necessary.

Menopause and Osteoporosis

Osteoporosis and menopause do not necessarily have to be an inevitable result of menopause.   Osteoporosis, which is a reduction in bone mass leading to fractures, can be reduced through diet and exercise.  Women who are diagnosed with osteoporosis tend to become more sedentary as they are fearful of doing something that might result in a fracture.  This a contrary to what she should actually be doing to help fight and reduce the risk of post-menopausal osteoporosis.  The post-menopausal woman who lives her life with prolonged inactivity and a sedentary lifestyle is at a greater risk for bone fractures and potential long term or permanent disability.  Physicians and other health care providers recommend a high intensity bone strength training regimen which includes low impact weight bearing exercise therapy along with walking.  Resistance training, walking, tai chi and low impact aerobics are fundamental to maintaining healthy bone mass and in many cases help to reverse osteoporosis in the post-menopausal female.  The goal is increased bone mineral density.  Secondary prevention, after exercise, includes   utilizing various pharmacological drug approaches recommended by a physician which can help to reduce the risk of vertebral, (spinal) non-vertebral, hip and wrist fractures.  It is important to note that medications are only secondary to exercise therapy which is the true factor in the reduction of fractures (Taylor & LaValleur, 2004).

Menopause and Sexual Intimacy

Sexual intimacy does not end with menopause and for many couples it gets better.  The focus of sexual intimacy changes from the reproductive aspect to the pure pleasure of being close your partner without the worry of an unwanted pregnancy.  There are some physical changes as one age that can affect the desire and the need for physical intimacy which continue through life into old age.  Vaginal dryness can be reduced by using a non-petroleum based lubricant such as K-Y jelly which is water based and leaves no oily after effect.  These products ate now available, in various scents, flavors and  warmth  and pleasure stimulating his and hers products, among others  which are safe, easy to use and available at your local pharmacy in the  feminine product aisle, Many couples  enjoy experimenting with different products to  find out what works best.  Orgasm may take a little longer to achieve so each couple will want to explore new ways to prolong foreplay for a more satisfying end result for both partners.  Sexual toys are also a fun and innovative way to bring more pleasure to both partners and shopping together for them can be an added adventure.  Menopause does not mean the end of sexual intimacy but it does bring about an opportunity to be creative and to spend time just enjoying the time you spend together as a couple.