October 31, 2014
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Cancer

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Easing symptoms of menopause

The most common treatment for menopausal symptoms is hormone replacement therapy (HRT) with estrogens and progesterones, the female hormones. However, after breast cancer, we are not sure if these agents are safe. We know that estrogens do cause a slightly increased risk of breast cancer and that in the laboratory, progesterones may stimulate breast cancer cells to grow. We also know that antiestrogens, a class of medications, decrease the risk of breast cancer.

There are concerns that estrogen may cause either a new cancer or your primary cancer to recur. Although this has not been proven and research continues to find the relationship of HRT and breast cancer, most doctors are reluctant to prescribe estrogens to women who have a history of breast cancer.

If a woman has severe symptoms that affect her quality of life, and no other treatments have been effective, HRT may be used on a short term basis on the understanding that there are questions about its safety.

What can you do to ease the symptoms of menopause?

  • Stop smoking
    • This can cause heart disease, osteoporosis and cancer.
  • Exercise regularly
    • Weight bearing exercise for your bones and cardiopulmonary exercise for your heart.
  • Check your diet
    • Make sure you have adequate calcium, low fat, and plenty of fruit and vegetables.

More specifically, if you suffer from:

  • Hot flushes:
    • Avoid things that stimulate hot flushes - caffeine, cola, chocolate, alcohol, stress, hot weather, saunas, etc.
    • Progestins may decrease flushes. If very severe, a low dose of estrogen may be the only option.
  • Vaginal dryness:
    • Try using a lubricant such as Replens® or Astroglide®
    • If severe, a small dose of estrogen cream (Premarin®), estrogen gel (Estrogel®), or estrogen ring (Estring®, a ring with estrogen which remains in your vagina) can be used (available by prescription from your doctor).
  • Osteoporosis:
    • Do weight bearing exercise and maintain a balanced diet.
    • Take calcium 1500 - 2000 mg and vitamin D 400 - 800 IU supplements.
    • Try prescription mediations such as bisphosphanates (e.g., Actonel®, Didrocal®, Fosamax® or selective estrogen reuptake modulators (e.g., Evista®)
  • Heart disease:
    • Have a healthy diet, and exercise.
    • Check your triglycerides and cholesterol levels and treat if high.

Many of the symptoms of menopause improve over time. Talk with your doctor about what you can do to make this time of your life easier.

 
Karen Gelmon, MD
 
in association with the MediResource Clinical Team


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