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Transcript

Menopause occurs when there are no
menses for one year

The ovaries become dormant and stop
making estrogen

95% of women complete menopause
between ages 45-55, with a mean age
of 51 years

A lucky few breeze through with minimal
ill effects….

But the majority of women experience
some degree of menopausal symptoms
› Hot flashes
› Mood lability
› Trouble sleeping
› Vaginal atrophy

The vaginal tissues are very sensitive to
estrogen, and estrogen deficiency leads
to thinning of the tissues. This is called
vaginal atrophy or “atrophic vaginitis”

Symptoms of atrophic vaginitis
› Dryness
› Itching
› Burning
Pain with intercourse
Urinary frequency
Frequent urinary infections

Taking medications which contain
estrogen (with or without progesterone)
when the body no longer makes it

Hormone replacement is the best way to
alleviate the undesirable effects of
menopause

A clinical trial showed that in some
women, hormone therapy may increase
risk of
› Cardiovascular problems (heart attack and
stroke)
› Blood clots
› Breast cancer
› Uterine Cancer
Women who have moderate-severe hot
flashes
 Women who suffer from symptoms of
vaginal atrophy
 Women who have NO personal history of

›
›
›
›
›
Breast, Ovarian, or Endometrial Cancer
Heart Attack
Stroke
Blood clots
Liver Disease
Women who went through menopause
prior to age 45
 Some women with osteoporosis
 Women who do not smoke
 Ideally, women who are younger than 60


Women with a family history of breast cancer need
to have a conversation with their doctors to weigh
their own personal potential risks and benefits
Oral tablets
 Patches
 Vaginal creams*
 Vaginal tablets*
 Vaginal rings*


The vaginal preparations work better for vaginal
atrophy and in low dose preparations, probably
have less systemic side effects

Hormone replacement therapy is not all
good, but it is NOT all bad!

You should take the lowest effective
dose, for the least amount of time
necessary
› Most women do well with 1-2 years of
therapy
› Ideally less than 5 years

Some women cannot, or elect not to,
take hormone replacement therapy
›
›
›
›
›

Keep cool!
Minimize caffeine and alcohol intake
Keep weight down
Don’t smoke
Acupuncture?
Some medications used for depression
can help with mood swings and even
hot flashes

“Phytoestrogens”
› Soy, isoflavones, red clover, flaxseed
› Compounds found in many plants, fruits,
vegetables
› Mimics estrogen effects in the body

Black Cohosh
› Mimics estrogen effects, especially on the
breast. Therefore it is not safe for those with
breast cancer or high risk.

Evening Primrose Oil
› Has not been proven to be effective

None have been proven to be more
effective than placebo for alleviating
menopausal hot flashes

They may increase breast cancer risk or
encourage tumor growth

Bottom line – probably not worth the
money.

Hormone replacement therapy is not for
everyone, but can be very safe and
effective for many women!

Talk with your doctor!