Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Hot flashes are symptom, not a medical condition. Through a thorough
medical history, the healthcare practitioner will usually be able to determine
whether a woman is having hot flashes. The patient will be asked to describe the hot
flashes, including how often and when they occur, and if there are other
associated symptoms. A physical examination together with the medical history
can help determine the cause of the hot flashes and direct further testing if
necessary.
Blood tests may be performed if the diagnosis is
unclear, either to measure hormone levels or to look for signs of other
conditions (such as infection) that
could be responsible for the hot flashes.
What is the treatment for hot flashes?
There are a variety of treatments for hot flashes such as:
hormone therapy,
bioidentical hormone therapy,
other drug treatments,
complementary and alternative treatments,
phytoestrogens,
black cohosh, and
other alternative therapies.
Some of these have not been proven by clinical studies, nor are they approved
by the FDA.
Hormone Therapy
Traditionally, hot flashes have been treated with either
oral or transdermal (patch) forms of estrogen. Hormone therapy (HT), also
referred to as hormone replacement therapy (HRT) or postmenopausal hormone
therapy (PHT), consists of estrogens alone or a combination of estrogens and
progesterone (progestin). All available prescription estrogen medications, whether oral or transdermal; are
effective in reducing the frequency of hot flashes and their severity. Research
indicates that these medications decrease the frequency of hot flashes by about
80% to 90%.
However, long-term studies (the NIH-sponsored Women's
Health Initiative, or WHI) of women receiving combined hormone therapy with both
estrogen and progesterone were halted when it was discovered that these women
had an increased risk for heart attack, stroke, and breast cancer when compared
with women who did not receive hormone therapy. Later studies of women taking estrogen
therapy alone showed that estrogen was associated with an increased risk for
stroke, but not for heart attack or breast cancer. Estrogen therapy alone,
however, is associated with an increased risk of developing
endometrial cancer
(cancer of the lining of the uterus) in postmenopausal women who have not had their uterus
surgically removed.
More recently, it has been noted that the negative effects associated with
hormone therapy were described in older women who were years beyond menopause, and some researchers have suggested that these negative outcomes
might be lessened or prevented if hormone therapy was given to younger women
(prior to or around the age of menopause) instead of women years beyond
menopause.
The decision in regard to starting or continuing hormone therapy, therefore,
is an individual one in which the patient and doctor must take into account the
inherent risks and benefits of the treatment along with each woman's own medical
history. It is currently recommended that if hormone therapy is used, it should
be used at the smallest effective dose for the shortest possible time.
Night sweats are severe hot flashes that occur at night and result in a drenching sweat. In order to distinguish night sweats that arise from medical causes from those that occur because one's surroundings are too warm, doctors generally refer to true night sweats as severe hot flashes occurring at night that can drench sleepwear and sheets, which are not related to an overheated environment.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the “change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.
Hot flashes are experienced by many women, however, not all women undergoing menopause experience hot flashes. A hot flash is a feeling of warmth that spreads over the body. Treatment for hot flashes include hormone replacement therapy and alternative prescription medications such as SSRIs (Effexor, Paxil, Prozac), clonidine (Catapres), megestrol (Megace), and gabapentin (Neurontin). Few alternative treatments for hot flashes (for example phytoestrogens - isoflavones, black cohosh, and vitamin E have been scientifically studied.
A carcinoid tumor is a tumor that develops from enterochromaffin cells. The important characteristic of carcinoid tumors that sets them apart from other gastrointestinal tract tumors, is their potential to cause the carcinoid syndrome. Local symptoms may include abdominal pain, intestinal bleeding, and intestinal obstruction. However, often symptoms of the carcinoid syndrome can be more devastating than the local symptoms. There are many options for the treatment of carcinoid tumors and carcinoid syndrome.
Male menopause refers to the decline in testosterone production in men. As men age, they often experience many of the same symptoms that women experience in menopause. Testosterone replacement therapy may relieve some of these symptoms.
Stress may be considered as any physical, chemical, or emotional factor that causes bodily or mental unrest and that may be a factor in disease causation. An important goal for those under stress is the management of stress in our lives. Elimination of stress is unrealistic, since stress is a part of normal life. We can however, learn to manage stress through techniques such as exercise, relaxation, meditation, time management, and support systems so that we have control over our stress and its effects on our physical and mental health.
Premenstrual dysphoric disorder (PMDD) is considered to be a severe form of premenstrual syndrome (PMS). PMDD has also been referred to as late luteal phase dysphoric disorder. The cause of PMDD is unknown. Some of the common symptoms of PMDD (not an inclusive list) include: mood swings, bloating, fatigue, headache, irritability, headache, breast tenderness, acne, hot flashes and more. Treatment for PMDD is with medication to treat the symptoms of PMDD.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Vaginal dryness and vaginal atrophy occurs in women during perimenopause, menopause, and postmenopause. With vaginal atrophy, the lining of the vaginal wall becomes thinner, drier, less elastic, and light pink to bluish in color. Symptoms of vaginal atrophy include vaginal dryness, itching, irritation, and/or pain during intercourse. Treatment options for vaginal dryness and vaginal atrophy include hormone treatment and over-the-counter vaginal lubricating and moisturizing products.
Premature menopause is when a woman goes through menopause before the age of 40 because of genetics, illness, or a medical procedure. Symptoms of premature menopause include irregular or missed periods, mood swings, hot flashes, periods that are heavier or lighter than usual, vaginal dryness, bladder irritability, incontinence, dry skin, eyes or mouth, sleeplessness, and decreased sex drive. Though premature menopause cannot be reversed, the symptoms can be managed with methods similar to those used for natural menopause.
Premature ovarian failure (POS) is the cessation of normal functioning of the ovaries in women under the age of 40. Premature ovarian failure may be caused by follicle depletion or dysfunction. The most common symptom of premature ovarian failure are irregular periods. There is no "treatment" that will restore the ovarian function, but there are treatments that my relieve symptoms.
Surgical menopause happens when a premenopausal woman has her ovaries removed in a surgical procedure called a bilateral oophorectomy. An abrupt menopause follows, with women often experiencing more severe menopausal symptoms than if they were to go through natural menopause. Chemotherapy and pelvic radiation therapy may also cause menopause by damaging the ovaries.
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