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MenoPause Blog

More About Menopause Symptoms—Tired and Cranky?

by JoAnn Pinkerton | Oct 18, 2016


We're pleased to have a guest post from Dr. Katherine Newton.









Katherine M. Newton, PhD
NAMS Board Member

We often think of hot flashes as the most troublesome, and sometimes the only, menopause symptom—and we tend to think that estrogen is our only treatment option. Estrogen works well, but many women prefer not to use, or cannot use, this hormone. And as our research has matured, so has our view of this important stage in a woman’s life. Whereas some women are very bothered by hot flashes, for others it is the mood changes and sleep disturbances that lead them to ask for help. The menopause transition is a time of increased risk for both a recurrence of depression and a first-time episode of depression. It isn’t so much the hot flashes but the fatigue and crankiness or depression that women sometimes find most difficult. So, what about treatments for these other important menopause symptoms?

If the primary symptom bothering you is mood, there are some good alternatives that may not only help with mood but with hot flashes as well. Several antidepressants in the SSRI (selective serotonin reuptake inhibitor) and SNRI (serotonin–norepinephrine reuptake inhibitor) categories can be used to treat the mood changes of menopause. Those that may also help with hot flashes include paroxetine, escitalopram, citalopram, venlafaxine, and desvenlafaxine.

What about sleep? A drug called gabapentin, which is approved to treat epilepsy, can help with hot flashes and has a sedative effect. If it is taken at bedtime, the drowsiness it causes may help you to sleep better. An approach called cognitive behavioral therapy for insomnia works very well to improve sleep in menopausal women with insomnia. This approach requires either attending a series of classes or receiving the counseling over the phone.

Are there nonpharmaceutical approaches that can help? Yes. Although yoga and exercise don’t appear to decrease hot flashes, they can improve mood and sleep and may decrease how bothered you are by your hot flashes.

All these therapies have their pros and cons. You should discuss all your symptoms with your healthcare provider to come up with the treatment regimen best suited to your needs.



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JoAnn V. Pinkerton, MD, NCMP
Executive Director

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