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Dietary changes like a reduction of consumption of alcohol, citrus
juices, caffeine, spicy foods, and artificial sweeteners can provide
some relief if you suffer from bladder related problems during
menopause.
Get your doctor’s advice as to whether changing some medications
might provide some relief.
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20. Menopause and Cancer
Cancer is a debilitating disease. It requires many prolonged
treatments, therapies, and medications. The impact of these
treatments and therapies is not the same for all women.
Cancer often requires radiation and chemotherapy treatment. These
treatments can damage your ovaries and bring on early menopause.
Sometimes they cause irregular periods, which later develop into
menopause.
If you are diagnosed with cancer in your youth and seek
chemotherapy treatment, you stand a greater chance of having a
premature menopause. When this is a sudden change, you
experience severe menopausal symptoms like hot flashes, poor sex
drive, depression, and irritability.
Women in their menopause have a higher risk of developing cancer
than women in pre-menopause stages due to poor resistance. In
some cases, the age of reaching menopause may affect their
chances of developing cancer.
A long reproductive period may give a woman higher than average
estrogen levels and that may increase their greater risk of
developing these cancers in their menopause to some degree.
Women undergoing hormone replacement therapy record higher
instances of breast cancer.
Chances of ovarian cancer are higher with women with higher
ovulation. So, women with a longer than average menstrual history
have had many ovulations and may have a higher risk of ovarian
cancer.
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21. Menopause and Osteoporosis
Menopause may be a factor in the development of osteoporosis.
Osteoporosis is general weakening of bones where bones tend to
lose more density than the amount they form.
Excessive bone mass loss is osteoporosis. This disease has no
warning symptoms. You often only realize its presence only when
you suffer a fracture. More than 20% of expected bone loss in your
lifetime occurs during the first five to seven years of your
menopause.
Menopause involves falling estrogen levels in your body. Estrogen
plays an important role in building of the bones in your body.
Osteoblasts are small cells within your body. These cells build up
your bones with the help of estrogen. However, low estrogen levels
during menopause reduce the easy and quick buildup of bones.
When the bones start wearing out faster than the rate of rebuilding,
they become weak and osteoporosis sets in.
Osteoporosis is treatable to some extent and doctors advise
relevant therapies and treatments to overcome or prevent
osteoporosis.
Although you cannot increase estrogen levels in your body, you can
take better care of your bones.
Eat calcium-rich foods like milk and yogurt, take calcium
supplements, and increase vitamin D levels in your body.
Vitamin D is essential for calcium absorption in your body. Drinking
vitamin-D fortified milk is a good option. You can take additional
vitamin supplements in consultation with your doctor.
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Regular exercises, like walking, keep your muscles stronger and
better toned.
Although exercises cannot stop bone loss, a regular program can
help to slow down the pace of osteoporosis.
Exercises increase overall fitness and may reduce the damage
sustained by falls.
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22. Menopause and Smoking
Smoking influences the onset of menopause greatly. Women who
smoke cigarettes regularly have a greater risk of entering
menopause around one to three years earlier than those that don’t
smoke according to some medical research and studies.
Smoking cigarettes causes inhalation of tobacco smoke The nicotine
that is present in cigarettes can affects the central nervous system,
causing numerous changes in hormone secretions. These changes in
hormonal levels may be a factor in the early menopause.
An early menopause may make you more susceptible to heart
diseases and osteoporosis.
As these conditions reduce your resistance to common menopausal
symptoms like hot flashes, night sweats, irregular sleep patterns
and irregular periods they have greater effect. You may, therefore,
experience a more intense menopause.
Women concentrating on their career tend to delay having their first
child.
Smoking may also increase your chances of developing ovarian,
uterine, or cervical cancers. In some cases, these cancers remain
undetected for long and that may lead to ovarian failure.
Giving up smoking is claimed by some to sometimes help delay the
onset of menopause which may help you to combat menopausal
symptoms better when they occur.
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Part-V: Treatment Options
23. Treatment Options for Menopause Symptoms
Menopause is a natural occurrence in women. It is not a disease
that needs treatment. Menopause is often accompanied by
symptoms that require suitable treatments
Common menopausal symptoms include hot flashes, heavy and
irregular bleeding, mood changes, irregular sleep patterns and
depression.
Treatment Options for Menopause Symptoms
Irregular and Heavy Periods
This bleeding is due to low progesterone levels in your body.
Doctors may prescribe birth control pills, non-steroidal anti-
inflammatory drugs (NSAIDs) or a levonorgestrel (LNg) IUD to
combat heavy bleeding.
Surgical procedures, like removal of the uterus (hysterectomy) can
offer a permanent solution.
Some claim that surgical application of heat to scar the uterus walls
can prevent or reduce heavy bleeding.
Hot flashes
This is a very common menopausal symptom. Low-dose hormone
therapy, high blood pressure medication clonidine, selective
serotonin reuptake inhibitors (SSRIs), antidepressants like
fluoxetine and paroxetine or anti-seizure medication gabapentin or
Neurontin may offer relief from hot flashes.
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Multiple symptoms
If you suffer from multiple severe menopause symptoms, some say
that hormone therapies may be the best treatment option.
Low-dose hormone replacement therapy with estrogen and
progestin may bring relief from heavy bleeding. You might consult
your doctor whether using low-dose estrogen-progestin birth control
pills would be a suitable option.
Vaginal dryness and irritation
Vaginal muscles lose their elasticity during menopause; dryness and
irritation are common.
Vaginal lubricants like estrogen creams and tablets can combat
dryness of skin and help to relieve the irritation.
Vaginal application may cause lower absorption of these estrogen-
based creams into your system and this might be an option with
reduced risk.
Treatment Options for Menopause Symptoms
Hormone therapy
This is the most popular and effective treatment option for hot
flashes, a menopausal symptom.
Doctors prescribe estrogen in low doses after considering other
factors such as your family medical history.
Many use this therapy as a short-term treatment option.
Initially, it was thought that this therapy provided protection against
heart disease and dementia. Of late, however, research results
show otherwise.
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Some women may suffer stroke, heart attack, or blood clotting after
more than one year of using this therapy.
Regular use of therapy for many years may increase the risks of
breast and ovarian cancers.
But, the incidence of these risks do not relate just to hormone
therapy alone. Your physical condition may also play a major role.
Bioidentical hormone replacement therapy (BHRT):
This is a new hormone therapy treatment.
Scientists produce hormones from plants like soy and yams, or from
animal sources like horses and pigs.
They treat these hormones with chemicals in laboratories and
produce synthetic hormones.
The molecular composition of these synthetic hormones is very
similar to that of natural hormones.
They are available in the form of oral pills, gels, creams and other
formulations.
These therapies are yet to record an established success rate. They
may have the same risks as those of hormone replacement therapy,
like the increased chance of heart disease, cancer, blood clots and
dementia.
Herbal remedies
There are some herbal preparations that are claimed to provide
relief from emotional upsets and to help to control excessive
aggression.
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Some people claim that certain herbal extracts and potions may
bring relief from menopausal symptoms.
Always consult your doctor before buying or using any of the
preparations in this section.
Black cohosh is claimed to alleviate depression and hot flashes.
There are unconfirmed reports that it may increase the risks of
uterine and breast cancer.
The changes in hormone levels during menopause may cause
severe emotional disturbances like mood swings, depression, and
irritability. Some people suggest that yoga, meditation, deep
breathing, and biofeedback may help to control your emotional
symptoms associated with menopause.
Lifestyle Changes
Adopting a healthier lifestyle may reduce the impact of menopause
symptoms.
Eat a regular and balanced diet.
Reduce or eliminate your alcohol and caffeine intake.
Quit smoking.
Make exercise a regular part of your daily life. You can choose from
many forms of physical exercise to help to maintain body fitness
and build up or protect healthy muscles and bones.
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24. Medications
Menopause causes potentially serious symptoms like hot flashes,
night sweats, fatigue, irritability, depression, irregular bleeding and
mood swings.
Some medications offer relief from such symptoms.
Hormone replacement therapy
This is a very popular treatment option. Many women take hormone
therapy treatment for a short-term and at a low dosage. Hormone
replacement therapy is believed to increase the risk of serious
health problems like heart diseases, cancer, dementia, strokes, and
blood clots if used over long periods.
So, many women opt for non-hormonal treatments and medications
to get relief.
Some people claim that most menopause symptoms can be relieved
to some degree by non-hormonal or hormonal medications for
menopause symptoms.
Common Medications for Menopausal Symptoms
Non-hormonal
Clonidine: This medication is said to be in common use among
high-pressure patients. It is claimed to be effective against hot
flashes as experienced during menopause.
Some women report side effects of this medication like low blood
pressure and dizziness.
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Belladonna (Bellergal): This medication contains Phenobarbital. It
is claimed to lower the effects of hot flashes. It can cause sleepiness
and should be only ever used for a short period. It is addictive.
SSRIs: SSRIs are selective serotonin reuptake inhibitors. They
are antidepressant medications like Paxil or Prozac.
It is claimed that they can bring relief from hot flashes; you
experience fewer flashes and with lesser severity.
However, there is no clear indication of how safe they are for long-
term use.
Gabapentin or Neurontin: This is an anti-seizure medication. It is
claimed to reduce hot flashes. It can cause a few side effects like
dizziness, sleepiness and swelling.
Medications for bone loss: Raloxifene, Calcitonin and
bisphosphonates are claimed to help reduce bone loss due to
menopause, thereby reducing risks of fractures and dislocations.
Hormonal
Progestin pills: These pills like levonorgestrel IUD release
progesterone into the uterus. It is claimed that they help control
irregular and heavy menstrual bleeding during perimenopause.
It is claimed that there are few minor side effects of these pills.
Birth control pills: These pills contain estrogen and progestin.
They can regulate menstrual bleeding. However, you should take
these pills only until menopause.
They are said to have side effects. Low-dose pills are available for
women over the age of 35.
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Stay away from this medication if you suffer from diabetes,
cardiovascular disease, high blood pressure or if you have had
breast cancer. Smokers also should not take these pills.
Vaginal estrogen medications: These are available in the form of
tablets, creams or rings. They alleviate urethral and vaginal dryness
and irritation without changing your body’s estrogen levels.
Progesterone creams: These creams may help to correct low
progesterone levels. They also may give serious side effects like
headaches, blood clots, and breast cancer or increase the risk of
uterine cancer in some cases.
Low-dose estrogen: A small dose of daily estrogen may help to
maintain good health and make your bones strong. However, the
effects of long-term use of estrogen is not very clear.
Estrogen therapy is claimed to provide relief from hot flashes,
improve cholesterol levels and reduce the risk of fractures. It is
claimed to be beneficial in treating urinary infections and vaginal
problems due to menopause.
Side effects including stroke, gallstones, painful intercourse, and
blood clots may occur.
It does not prevent pregnancy.
Hormone Therapy: Hormone therapy involves taking estrogen
with progesterone according to your doctor’s specifications.
Continuous use of this therapy may increase the risk of breast
cancer.
Testosterone-estrogen: If estrogen therapy is unable to give you
the desired relief from menopausal symptoms, you might be
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advised, subject to your doctor’s advice, to try Testosterone-
estrogen.
This is a new therapy and it does not have FDA approval. Long-term
use may cause serious side effects like facial hair growth, hair loss,
acne and deepening of your voice.
It may also increase your risk of heart ailments, stroke, blood clots
and breast cancer.
Doctors do not advise this for menopausal women except in special
cases.
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25. Hormone Replacement Therapy (HRT)
Hormone replacement therapy involves replacing the hormones
that your body no longer produces to alleviate symptoms associated
with menopause. Menopause can involve debilitating symptoms like
hot flashes, fatigue, irritability, night sweats, depression and mood
swings.
Menopause causes erratic production of hormones in your body.
These unpredictable levels can trigger severe symptoms.
Doctors sometimes recommend hormone replacement therapy to
overcome severe menopausal symptoms.
Before starting on hormone replacement therapy, doctors advise
various tests. Blood tests help determine cholesterol levels.
Your individual constitution requires thorough analysis to see how
good this therapy may be for you.
Doctors start with low doses and may increase doses according to
the results you get.
Benefits
Hormone replacement therapy has been claimed to have many
benefits:
It may manage your menopausal symptoms because it increases
your body’s hormone levels to where you suffer less from hot
flashes, vaginal irritation or fatigue.
Low estrogen levels increase chances of osteoporosis. This therapy
can help to increase estrogen levels and may reduce the
osteoporosis risk.
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Low estrogen levels could increase the chance of heart diseases.
With hormone replacement therapy, estrogen levels increase and
that may lower the risks of heart ailments. But, this is more likely if
you are not a smoker and have good health.
Risks
Hormone replacement therapy may carry some inherent risks like
increased risk of uterine and ovarian cancer. But, these risks are
probably, in part, also dependent on other factors, including your
genetic history, your medical history of ailments like cancer or a
family history of serious ailments.
It may be difficult to arrive at a suitable dose of hormones in your
hormone replacement therapy. Hormonal loss is very individualistic,
so your doctor has to be very careful when judging how much
hormones you require and how much hormones your body is
actually producing.
This therapy can have its own side effects such as:
headaches leading to migraines,
excessive weight gain, especially around hips and
fatigue.
HRT may also cause excessive fluid retention, resulting in swollen
ankles, facial swelling, breast tenderness and pain in the legs.
Such excess fluid is normally reduced within the first few months of
therapy.
Nausea and vomiting are other common side effects. Taking
hormonal injections or having hormonal pills after a small snack at
bedtime can reduce such feelings.
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HRT can induce heavy bleeding in the initial months. After a few
months, the bleeding may tend more to be within a specific pattern
and you could be better able to adjust to it.
HRT and Menopause
HRT has its advantages and risk factors. Recently, there have been
indications that HRT may be a factor in women who take it getting
various serious diseases like cancer and heart ailments.
These ailments could occur during the treatment or even long after
stopping the therapy. In that context, many are wary of going in for
this treatment.
You should discuss whether the advantages for you are greater than
the risks.
Precautions
Another way of possibly reducing the possible risks of HRT is to take
a few precautions:
• Consider a low estrogen dosage, in the form of vaginal
creams, to provide necessary relief and perhaps reduce the
chance of serious problems.
• Have scheduled pap smears and regular pelvic examinations
to assist early detection of any problems.
• Regular mammograms and breast examinations are also
essential.
Other tactics to reduce potential negative effects of HRT include:
• avoiding spicy foods, caffeine, and alcohol,
• use relaxation techniques like meditation, yoga, deep
breathing
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• practice Kegel exercises regularly
• have an active sex life
• include soy foods in daily diet, and
• use water-based lubricants during intercourse to prevent
vaginal pain and irritation.
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