Am I in menopause?
Menopause is defined as no period for one year due to a loss of ovarian function. The average age for menopause is 51. However, women may begin to experience menopausal symptoms such as hot flashes, mood swings and menstrual irregularity for several years before her periods end. This is commonly referred to the perimenopause.
Should I take hormones?
Unfortunately, there is no easy answer to this question. Recently the results of the Women's Health Initiative (WHI) and Heart and Estrogen/Progestin Replacement Study (HERS) study have only added to the dilemma by demonstrating an increased risk of breast cancer, heart disease and stroke.
Each woman is a unique individual with her own set of risks, history, concerns and worries. Now more than ever it is important for her to review her needs with her provider and develop a regimen that can address those needs.
What side effects will I have on hormones?
Some of the more common side effects are water retention, breast tenderness and headaches. These side effects tend to resolve after the first two months on hormones. Many women are opting to use bio-identical hormones to minimize these and other side effects.
If irregular bleeding should occur consult your physician immediately.
What are bio-identical hormones?
The term, bio-identical refers to the estrogens and progesterones that women produce naturally prior to menopause. The primary hormones are estradiol, estrone, estriol and progesterone.
For many years, physicians have been prescribing bio-identical hormone replacement therapy as an alternative to a synthetic hormone. A benefit of bio-identical hormone replacement therapy is that they can be customized, in strength and dosage form, for the individual and her specific needs
Where can I get bio-identical hormones?
There are a variety of sources for bio-identical hormones. Many products are readily available at the pharmacist, such as the patches Climara (Berlex) and Vivelle (Ciba-Geigy), oral pills Estrace (Bristol-Myers Squibb) and Estratest(Solvay) and Prometrium (Solvay).
A compounding pharmacy can customize the dosage, strength and combination of hormones for you based upon the regimen developed by you and your provider.
Local compounding pharmacies:
- Westwood Pharmacy; 408-266-7000
- Silicon Valley Pharmacy; 408-378-5381
Your local pharmacist may also compound medications for you.
What alternatives to hormones can I use to treat my hot flashes?
At this time the best studied non-hormonal treatment for hot flashes are antidepressants such as Effexor and Prozac. Clinical trials have demonstrated a 50-60% reduction in the number of hot flash episodes experienced by women. Some common side effects from these medications are dry mouth, headaches and decreased appetite. These symptoms usually resolve after about two weeks. Some anecdotal evidence has also demonstrated that gabapentin (Neurontoin), an anticonvulsant, may also reduce hot flashes.
Plant estrogens such as those found in soy foods have been shown to reduce hot flashes. There are currently two large studies looking at the use of soy estrogens for the treatment of hot flashes. Although the studies are not complete, many participants have noticed a significant reduction in symptoms with 150 mg. per day of soy estrogens. Another source of plant estrogens, phytoestrogens, is Promensil.
Supplements such as vitamin E, black cohosh, dong quai, and evening primrose oil have also helped to relive women of their symptoms. Both, dong quai and black cohosh should be avoided if a woman is experiencing heavy bleeding.
As with any medications or supplements, consult your physician before beginning treatment.
Where can I get more information about menopause?