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Menopause Research

Menopause Research

The following information was gathered through our extensive research on the side effects of Breast Cancer. Please let us know of any sites and/or pages that you feel are important for others to know about and consider adding them to our pages. You can also find more links on our User Submitted Links page.


About Menopause

This is the beginning of our own research and experiences with Menopause. It will begin as an outline and then fill in with a wealth of material and experiences. Please contact us with any input and/or content you wish seen placed here.

I. Symptoms

Menopause refers to the time in a woman’s life when her menstrual periods stop, marking the end of her ability to conceive. The cessation of the menstrual cycle may take place over a year, but the biological changes (and some of the accompanying symptoms) begin several years earlier and continue throughout the menopausal phase. This is referred to as peri-menopausal. Menopause is a natural phenomenon, but like many life transitions it can be difficult.

The primary indicator of menopause is a significant change in, or cessation of, the menstrual cycle. Once a woman has not menstruated for a full year, menopause is considered complete; she is the post-menopausal. A diagnostic test can confirm menopause. The FSH test is a blood study that measures the body’s level of follicle stimulating hormone. As estrogen levels decline, the pituitary gland secretes FSH; therefore, a high level may indicate menopause. Blood and urine tests can also determine if a woman is still ovulating.

Other significant physical and psychological changes are commonly associated with menopause. The two most common are hot flashes (sudden sensations of heat, usually in the upper body, sometimes followed by chills) and vaginal dryness and atrophy. Hot flashes affect approximately 75% to 85% of women. They may occur before and around the menopausal period and will usually continue over a period of several months. (About 25 -50% of women report that they occur for more than five years)

II. Side Effects

  • menstrual irregularity followed by the cessation of monthly periods.
  • Hot flashes caused by the body thermometer not functioning well
  • vaginal dryness and discomfort accompanying cessation of monthly periods.
  • Headache, dizziness, and night sweats
  • Bloating, breast tenderness, and bladder irritability
  • Rapid mood changes, probably due to shifts in hormone levels, as well as tension and anxiety
  • Insomnia
  • Depression
  • Loss of sexual desire
  • Lack of concentration or difficulties with memory
  • Bone loss
  • Cardiovascular disease
  • Increased risk of breast, ovarian, and colon cancers

III  Treatments

A. Hormone Replacement Therapy

HRT, Hormone replacement therapy, is a combination of estrogen and progestin prescribed to women who haven't had a hysterectomy.  Progestin - either progesterone or a synthetically similar compound - is added because, given alone, estrogen can increase the risk of endometrial cancer.

 ERT, estrogen replacement therapy, estrogen alone is given to a woman who has had a hysterectomy, and hence, has no risk of endometrial cancer to worry about.

Estrogen is prescribed as a pill, but it can be delivered in a skin patch, injection, vaginal cream or ring.  The top selling estrogen replacement pill is PREMARIN which is derived from the urine of pregnant mares.  It has been used for more than 50 years and been the subject of more than 3,000 clinical studies.

The standard recommended dose for estrogen replacement is 0.625 mg daily, but each women is different.  Talk to your doctor.  Some doctors believe the lowest effective dosage is the best.  Find a doctor who is willing to adjust your dose until you are comfortable with the side effects. It's important to recognize that no decisions are set in stone.  Some researchers say that it is difficult to study this drug because many women stop taking it without consulting their doctor so the true value can not be determined.  You should never discontinue this treatment without discussing it with your physician. Hormone replacement is generally not advisable for a woman with a history of breast cancer, other cancers, or abnormal vaginal bleeding.  Doctors may also advise against it if you have liver disease, severe varicose veins, abnormal blood clotting, seizures, migraines, or gallbladder disease.  Talk to your doctor about the risk factors.

Estrogen replacement can be taken at the onset of menopause to reduce hot flashes, vaginal dryness, and mood swings.  More than 70 percent of women have symptoms lasting a year or more.  Some women require only short tern help, just long enough for their bodies to adjust to the changes in hormone levels that occur at menopause.  Others may need years, perhaps even a lifetime, if they're going to spend the rest of their lives in good working order.

It's believed that women who take estrogen can have as much as a 50 percent reduction in cardiovascular disease.  One study has shown that estrogen therapy- with or without progestin- may reduce your LDL, or bad cholesterol, and increase HDL, or good cholesterol.  It is important to request a cholesterol level test and determine your individual level of LDL and HDL.

Recent studies show that estrogen may help prevent colon cancer.  It may also improve learning, slow age-related memory loss, and stave off dementia.  A 16 year study shows that ERT was associated with a more than 50 percent reduced risk of developing Alzheimer's disease.  Another study found that estrogen may reduce the severity of Parkinson's disease.  Other possible benefits include an improved sex life, arthritis relief, younger-looking skin, and a reduced risk of cataracts.

B. Drug Therapy

Tamoxifen (Nolvadex) is the best known designer estrogen.  It has been used for 25 years to treat breast cancer and now has been approved by the FDA for use in preventing the disease. To achieve its benefits, tamoxifen, like the other designer drugs, lodges in receptors, or slots, on cell surfaces where estrogen normally fits.  Amazingly, in some tissues, tamoxifen fulfills some of the functions of estrogen, while in others it actually works to block harmful estrogen effects.  As an example, while estrogen can speed the growth of cancer cells in women with breast cancer, tamoxifen can cause death of cancer cells and protect against the development of breast cancer.

Raloxifene was approved by the FDA in December 1997 to help prevent osteoporosis in postmenopausal women.  Sold under the name Evista the drug is in a category of drugs known as SERMs - Selective Estrogen Receptor Modulators.  This means that the estrogen found in this drug will stimulate some tissues while inhibiting others.  So while Evista can help strengthen bones, it won't cause monthly bleeding and breast pain.

A two year study by the American Society of Clinical Oncology published last May found that Raloxifene may reduce the incidence of breast cancer by up to 66 percent and may reduce the risk of endometrial cancer in postmenopausal women.  It doesn't, however have nearly the same impact as ERT.  It can worsen hot flashes, cause leg cramps, and it isn't known to improve other menopausal symptoms.  It also increases the risk of serious blood clots and should not be taken at a time when a person is going to be laid up.  

The most common side effects are vaginal bleeding, bloating, breast tenderness, headaches and nausea.  Typically a change in dosage or application can eliminate side effects.  In rare cases, estrogen may increase your risk of gallbladder disease and blood clots in the legs and lungs.

Other SERMs that are being studied for treatment of osteoporosis in postmenopausal women include Droloxifene and Idoxifene.  Both of these SERMs are in clinical trials.  Phase III clinical trials began recently for Idoxifene.

C. Herbal Remedies

There are several plant-based estrogens on the market.  The FDA recently approved ESTRATAB to help prevent osteoporosis.  Estratab is a pill form of estrogen made from soy-beans and yams.  The lowest dosage approved was 0.3 mg.  The two major components of Estratab are the same as in Premarin.  What's different is the source.

As for natural supplements, such as St. John's Wort, ginseng, black cohosh, and dong quai, most experts advise caution.  They haven't been approved by the FDA for this use and safe doses have not been established.

D. Wellness healthy living issues

Some studies speculate that phyto-estrogens, found in foods such as beans, tofu and peas, could be the reason women in Japan seldom suffer hot flashes.  They east much more soy in their daily diet.

In the U.S., to get enough phyto-estrogens to reap any benefits, you would have to eat 22 servings of tofu a day or drink 64 ounces of soy milk.  We don't tend to eat that way.

Unfortunately, after menopause taking calcium and vitamin D (the vitamin which helps the body absorb calcium) is just a drop in the bucket compared to HRT.  The estrogen question is still there, and after menopause you're going to lose bone mass even if you do all that good stuff. The current recommended  dosage of calcium is 1500 mgs daily.

Request a bone density test to determine your risk or if you are already losing bone mass.  A new home test kit has appeared on the market and is easy to use.  You may wish to discuss the best way to analyze your situation.  Sometimes an x-ray of the wrist and ankles can be an indicator.

IV Resources

What's Right For Me?  800.561.2781 Free publication from The Wellness Councils of America

The Hormone Foundation  4350 East West Highway, Suite 500 Bethesda, MD 20814-4410  1.800.hormone

 

Disclaimer: The information presented on this site should NOT replace the advice of a qualified health care professional
and is NOT presented as qualified advice or council. Please use this information as a guide or reference point
when consulting with your private physician (s).

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