It is really your choice. If your hot flashes are not bothering you that much, you may want to just wait them out. Hot flashes generally become milder and less frequent as time goes on, and for most women they totally disappear. However, there are some women who have a long experience with hot flashes for several years, maybe longer, and then an occasional hot flash forever. The challenge is that no one can predict how long your hot flashes will persist. Hormone therapy provides very effective treatment for hot flashes, but it is not always a permanent cure. About forty percent of women have a return of their hot flashes when they stop treatment—somewhat like a second menopause when the estrogen level drops again.
There are a number of low-risk coping strategies and lifestyle changes that may be helpful to you for managing hot flashes, but if hot flashes remain very disruptive then prescription therapy can be considered. Prescription hormone therapy (HT) approved by the US Food and Drug Administration (FDA) and by Health Canada include systemic estrogen therapy (ET) and estrogen-progestogen therapy (EPT; for women with a uterus). Some of these treatments have been around for 70 years. A newer FDA-approved hormone product, for women with a uterus, combines estrogen with bazedoxifene instead of a progestogen. Bazedoxifene is an estrogen agonist/antagonist, which means that it works like estrogen in some tissues while inhibiting estrogen activity in others. In this case, it helps to protect the uterus from cancer. There are reasons why some women should not use HT and the list includes such things as a history of estrogen-related cancers such as breast cancer, a history of liver disease, blood clots in the legs or lungs, cardiovascular disease, and stroke. A review of your health history with your healthcare provider is an important first step.
For women who prefer not to take hormones or cannot take them for other health reasons, nonhormonal drugs approved to treat depression, called selective serotonin-reuptake inhibitors (SSRIs), have been found to be effective in treating hot flashes in women who don’t have depression. The only SSRI the FDA has approved thus far for treating hot flashes is paroxetine 7.5 mg. It was shown to improve hot flashes and offers women a new choice. Discuss with your healthcare provider all of these options to see which ones are appropriate for you.
Are you bothered by menopause symptoms and wondering what to do about it? Try our free MenoPro app available in the iTunes store. You can also read about it here.
The time has come. This is your opportunity to discuss your concerns and to share your thoughts on the need for treatment with the United States Food and Drug Administration (FDA). There have been many products brought to market over the last 15 years for male sexual dysfunction, but we still have nothing for women.
The most common female sexual dysfunction is female sexual interest/arousal disorder, often referred to as “low desire” or “low libido.” The FDA wants to hear from women who have this condition. How does it affect your life? What is the most distressing aspect of it? Has anything helped?
On October 27, 2014, the FDA is holding a Patient-Focused Drug Development public meeting on Female Sexual Dysfunction in Silver Springs, Maryland. You can apply to appear in person or submit your comments online. Webcast participants will also have an opportunity to provide input through webcast comments. A panel of patients and patient advocates will present comments to start the dialogue, followed by a facilitated discussion with all patients and patient representatives in the audience. I will be there in person in the audience to hear your comments, and I will also be participating on the scientific panel the following day.
All parts of the event are free but you must register online and by October 20, 2014. For event details and to learn more visit Eventbrite: Patient-Focused Drug Development Public Meeting and Scientific Workshop on Female Sexual Dysfunction event page.
For more information, refer to the FDA meeting website.
The North American Menopause Society maintains a search feature on this Web site for those women in the United States or Canada who are searching for physicians and other healthcare providers interested in helping them manage their health through menopause and beyond. Those who have passed a competency examination leading to the prestigious credential of NAMS Menopause Practitioner are noted in the displayed results.
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Posts to our Blog are written by NAMS staff members and Dr. Margery Gass. All posts are reviewed and edited by Dr. Gass. We strive to bring you the most recent and interesting information about various aspect of menopause and midlife health. We accept no advertising for our website. We want you to have accurate, unbiased, evidence-based information.
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