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Menopause: Making Peace With Change

Sunday, June 29, 2014

Can Hot Flashes And Menopausal Symptoms Be Completely Eliminated With Hormone Therapy?

Hot flashes in a menopausal woman comes from the aging ovaries inability to ovulate any longer and finally the shortage of eggs and withdrawal of and then chronically low levels of estrogen. Mostly hot flashes occur in women transitioning through menopause,, but women who have low estrogen for other hormone imbalance reasons can have hot flashes as well. Many women will have only months to just a few years of significant hot flashes, but we know they occur over many years for some women, and the average is much longer than the 5 years we used to assume they occur. Hot flashes can be completely eliminated by appropriate hormone therapy. Although not a 100% of women will respond with a complete treatment response and never have hot flashes. Most all women will respond with enough effect to be satisfied. Using modest and low dose hormone therapy makes it take awhile to treat. It is possible to successfully treat mild to moderate hot flashes with non-hormonal methods as well, and there are many, but few treatments replace the gold standard t\of menopausal therapy which is estrogen treatment. We have recently discovered low levels of antidepressant medication can work, and the medication Brisdelle is one example of a non-hormonal way to treat hot flashes. Being fit and eating correctly is important for management of all life stages but one of the largest hot flash studies unfortunately showed that exercise, although very health beneficial, doesn't treat hot flashes. Nor did yoga in this study actually treat hot flashes, but the patients did sleep better, in spite of residual hot flashes, when they participated in yoga. The most popular oral therapy to date has been using conjugated equine estrogens,  and this has lately been replaced in some women by bioidentical estradiol, is effective in the management of vasomotor symptoms of menopause. In an analysis of data from the Women’s Health Initiative (WHI) study use of estrogen therapy was associated with a 28% relative improvement in the relief of hot flashes compared with placebo and placebo cures hot flashes in about 20-30% of cases, although some women get literally 100% treatment success. The  key to successful therapy has been managing side effects and risk of all menopausal therapy. And for women with osteoporosis making sure they have appropriate dosing and medication to treat their bones, and women who have sexual complaints may need other management as well. For many women with atrophy the oral estrogen can be enough to treat vaginal atrophy as well, for many women they need direct vaginal treatment. For women who do not want direct vaginal estrogen treatment they may want to consider Co2 resurfacing of the vaginal tissues with the painless MonaLisa Touch therapy. This can be done by using lower dosing, dosing through the skin with either a patch or a topical application, and minimizing progesterone exposure. Other places to menopausal research include: the National Institute on Aging the National Institute on Complementary Medicine or the Office of Women's Health Research.

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Thank you for your comments and questions. This blog is not intended to replace medical care, but is informational only. We hope you will become a follower or visit Womens Health Practice. We offer a variety of unique services including MonaLisa Touch, Coolsculpting, Labiaplasty, and Gynecoloigic Clinical Research Trials. For more information on menopause see http://www.amazon.com/Menopause-Make-Peace-Change

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