Many women look forward to the end of having monthly periods but ultimately, they find, menopause is no walk in the park either.
Hot flashes, weight gain, vaginal dryness, painful sex and urinary tract infections can put a real damper on a woman’s sex life.
Dr. Lauren Streicher, a gynecologist who contributes articles and has been interviewed for many magazines, books and newspapers and the health expert for The Ladies Home Journal and a blogger on the Dr. Oz Show website and EverdayHealth.com, says there are several treatment options.
Those options, including estrogen and non-estrogen options to control flashes and lubricants, moisturizers, local vaginal estrogens and, now, Ospemifene, an oral non-estrogen pill designed to alleviate vaginal dryness, as well as Brisdelle, a non-estrogen drug aimed at relieving menopause symptoms.
Further, Streicher said, an estrogen patch or gel, especially when taken in the early stages of menopause, can be effective.
“New data emerged last year showing it appears to be safe for most newly menopausal women to use hormone therapy and that there appear to be advantages of transdermal estrogen therapy, particularly if a woman is diabetic or at risk for cardiovascular disease,” Streicher said.
“The Kronos Early Estrogen Prevention Study (KEEPS) was reassuring about using hormone therapy and proved that if estrogen therapy is started at the onset of menopause (as opposed to years later) there was excellent relief of symptoms with no increase in blood pressure, no effects on atherosclerosis, no increase in breast cancer, uterine cancer or blood clots, stroke or myocardial infarction. In addition, transdermal estrogens such as patches, sprays or gels did not affect cholesterol or triglycerides and lower insulin resistance.”
Streicher said increased life expectancy means women are having sex long past the onset of menopause and it is importance to address treatment concerns early.
“Midlife sexuality is important because right now the average age of menopause is 51,” Streicher told The Chicago Tribune in an interview. “Life expectancy is well into the 80s. Women are living almost half of their lives after the menopause transition, and female sexuality has not been addressed. This has an enormous impact, not only on women but on couples and relationships. In addition, we have a 50 percent divorce rate, where we have women who are newly single and starting new relationships at midlife.”
Streicher, author of The Essential Guide to Hysterectomy, is an associate clinical professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University. Her new comprehensive guide to sexual health. Love Sex Again: A Gynecologist Finally Fixes the Problems that are Sabotaging Your Sex Life will be released in 2014.
My gynecologist told me to use a lubricant, but sex still hurts.
First of all, all lubes are not created equal. Most lubricants are water based and not only don’t last very long, but can be sticky and irritating. A silicone lubricant, such as Wet Platinum, is far more slippery and long lasting. It would be nice if lubricants or moisturizers always solved the problem, but sometimes the ravages of menopause make the vaginal walls so thin and dry, that the only way to reverse the vaginal clock and make intercourse comfortable is to get a prescription for estrogen. While many women associate estrogen with breast cancer and blood clots, keep in mind that the FDA required warnings and complications listed on the package insert have never been shown to occur as a result of using a local vaginal estrogen product.
I heard there is a new non-estrogen pill to help vaginal dryness. What’s it called?
Ospemifene, (Osphena™) is a daily oral pill to alleviate painful intercourse as a result of post menopause vaginal dryness. Ospemifene is a selective estrogen receptor modulator (SERM) that specifically targets vaginal tissue, and like it’s cousin Raloxifene (Evista™), blocks estrogen receptors in breast tissue. It’s a great option for women who have been told not to take estrogen, prefer not to take estrogen, or simply like the idea of taking a pill instead of putting something in their vagina.
Is it true that using an estrogen patch or gel is better than taking estrogen pills?
It is true. New data emerged last year showing it appears to be safe for most newly menopausal women to use hormone therapy and that there appear to be advantages of transdermal estrogen therapy, particularly if a woman is diabetic or at risk for cardiovascular disease. The Kronos Early Estrogen Prevention Study (KEEPS) was reassuring about using hormone therapy and proved that if estrogen therapy is started at the onset of menopause (as opposed to years later) there was excellent relief of symptoms with no increase in blood pressure, no effects on atherosclerosis, no increase in breast cancer, uterine cancer or blood clots, stroke or myocardial infarction. In addition, transdermal estrogens such as patches, sprays or gels did not affect cholesterol or triglycerides and lower insulin resistance.
I have breast cancer and can’t use estrogen but the hot flashes are making me crazy. Any suggestions?
Help is around the corner. The FDA just approved a new non-estrogen drug for relief of menopause symptoms. Brisdelle will be available on November 1 and is a lower dose version of paroxetine, an SSRI specifically studied to relieve hot flashes. The dosage of Brisdelle approved for this use (7.5 mg) is far lower than the dose of paroxetine used to treat conditions such as major depressive disorder, obsessive-compulsive disorder, panic disorder, and generalized anxiety disorder. Because it is a lower dose, it has fewer side effects than seen in higher doses.
Where can I get accurate information about menopause?
The North American Menopause Society (menopause.org) not only has not only comprehensive information, and a monthly online newsletter, Menopause Flashes, for breaking news, but can also help you find a practitioner who is knowledgeable and interested in menopause.
Hot Flashes? Dryness? New Treatments Make Menopause Managable was originally published on blackamericaweb.com
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