Menopause (cont.)
Other pharmaceutical therapies
Antidepressant medications: The class of drugs known as
selective serotonin reuptake inhibitors (SSRIs) and related medications have been shown to be
effective in controlling the symptoms of hot flashes in up to 60% of women.
Specifically, venlafaxine (Effexor), a drug related to the SSRIs, and the SSRIs
fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram
(Celexa) have all been shown to decrease the severity of hot flashes in some
women. However, antidepressant medications may be associated with side effects,
including decreased libido or sexual
dysfunction.
Other medications: Other prescription medications have
been shown to provide some relief for hot flashes, although their specific
purpose is not the treatment of hot flashes. All of these may have side effects,
and their use should be discussed with and monitored by a doctor. Some of these
medications that have been shown to help relieve hot flashes include the antiseizure drug gabapentin (Neurontin) and clonidine
(Catapres), a drug used to treat high
blood pressure.
Alternative medical therapies
Plant estrogens (phytoestrogens, isoflavones)
Isoflavones are chemical compounds found in soy and other plants that are
phytoestrogens, or plant-derived estrogens. They have a chemical structure that
is similar to the estrogens naturally produced by the body, but their
effectiveness as an estrogen has been estimated to be much lower than true
estrogens. Their estrogen potency has been estimated to be only 1/1000 to
1/100,000 of that of estradiol, a natural estrogen.
Two types of isoflavones, genistein and daidzein, are found in soy beans,
chick peas, and lentils, and are considered to be the most potent estrogens of
the phytoestrogens.
Some studies have shown that these compounds may help
relieve hot flashes and other symptoms of menopause. In particular, women who
have had breast cancer and do not want to take hormone therapy (HT) with
estrogen sometimes use soy products for relief of menopausal symptoms. However,
some phytoestrogens can actually have anti-estrogenic properties in certain
situations, and the overall risks of these preparations have not yet been
determined. For example, researchers have shown that long-term use of
phytoestrogens in postmenopausal women led to an overgrowth of the tissues
lining the uterus (endometrial hyperplasia) which can be a precursor to cancer.
There is also a perception among many women that plant estrogens are
"natural" and therefore safer than HT, but this has never been proven
scientifically. Further research is needed to fully characterize the safety and
potential risks of phytoestrogens.
Vitamin E
Some women report that vitamin E supplements can provide relief from mild hot
flashes, but scientific studies are lacking to prove the effectiveness of
vitamin E in relieving symptoms of menopause. Taking a dosage greater than 400
international units (IU) of vitamin E may not be safe, since some studies have
suggested that greater dosages may be associated with cardiovascular disease
risk.
Black Cohosh
Black cohosh is an herbal preparation that has been
popular in Europe for the relief of hot flashes. This herb has become more and
more popular in the U.S., and the North American Menopause Society does support
the short-term use of black cohosh for treating menopausal symptoms, for a
period of up to six months, because of its relatively low incidence of side effects when used short term.
However, there have still been very few scientific studies done to establish the
benefits and safety of this product. Research is ongoing to further determine
the effectiveness and safety of black cohosh.
A large study known as the Herbal Alternatives for Menopause Trial (HALT) tested the effectiveness of different herbal or alternative ingredients versus estrogen therapy or placebo for the relief of menopausal symptoms. After one year of therapy, there was no significant reduction in the frequency or severity of hot flashes in women receiving any of the herbal preparations (including a group who received black cohosh) when compared to placebo at any of the follow-up times (3, 6, and 12 months).
Other alternative therapies
There are many supplements and substances that have been advertised as
"natural" treatments for symptoms of menopause, including licorice, dong quai,
chasteberry, and wild yam. Scientific studies
have not proven the safety or effectiveness of these products.
Next: Non-hormone therapies »
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