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For some women, hormone replacement therapy (HRT) introduces various life-threatening risks and should be avoided. Here are the most frequent medical problems that prohibit usage of this treatment:
- One of the common risks is a chance of breast, endometrial, and other hormone-dependent cancers. This treatment is only suggested after a thorough examination of existing medical problems and cancer cases in family history.
- There is an increased risk of venous thromboembolism (VTE) associated with HRT in women who are sedentary, overweight, or active smokers (Akter & Shirin, 2018).
- The risk of cardiovascular disease greatly increases in patients who had their last menstrual periods more than 10 years ago or who are 60 years old or older (Akter & Shirin, 2018).
Non-hormonal treatments, although less effective than HRT, are generally less dangerous and have less severe adverse effects. Clonidine is in a class of medications called centrally-active α2 agonists and anti-hypertensives. The dose usually starts at 25μg twice a day, increased, if tolerated, to 50-75μg twice a day over a two-week period. Side effects include problems with sleeping, dry mouth and constipation. The treatment lasts four weeks unless side effects are too severe.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant medications that are often prescribed by doctors first because of the least amount of side effects (Tsiligiannis, Maclaran, & Panay, 2018). The dosage starts at 10mg per day, increased to 20mg per day after one week. Side effects of SSRIs often include drowsiness, nausea, tremor, and weight fluctuations. If no benefits are observed after four weeks of treatment or side effects are too severe, it should be stopped.
A suggested healthy diet to reduce vasomotor symptoms (VMS) is a low-fat, high fruits, vegetables, and whole-grain diet. The Women’s Health Initiative Dietary Modification trial has shown that women with mild symptoms who lost weight were more likely to eliminate VMS at one year (Schwarz, 2017). Participants who lost ≥ 10% of body weight were 56% more likely to no longer report hot flushes and night sweats after one year (Schwarz, 2017). To reduce the symptoms, it is advised to avoid consumption of spicy food, alcohol, caffeine or hot foods/drinks.
References
Akter, M.J., & Shirin, E. (2018). Latest evidence on using hormone replacement therapy in the menopause. Journal of Bangladesh College of Physicians and Surgeons, 36(1), 26-32. Web.
Schwarz, R. (2017). A guide to treating the symptoms of menopause. Osteopathic Family Physician, 9(5). Web.
Tsiligiannis, S., Maclaran, K., & Panay, N. (2018). Treatment options for menopausal symptoms. The Pharmaceutical Journal, 300. Web.
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