Font Size

Menopause (cont.)

Bioidentical Hormone Therapy

There has been increasing interest in recent years in the use of so-called "bioidentical" hormone therapy for perimenopausal women. Bioidentical hormone preparations are medications that contain hormones that have the same chemical formula as those made naturally in the body. The hormones are created in a laboratory by altering compounds derived from naturally-occurring plant products. Some bioidentical hormone preparations are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. These individual preparations are not regulated by the FDA, because compounded products are not standardized.

Advocates of bioidentical hormone therapy argue that the products, applied as creams or gels, are absorbed into the body in their active form without the need for "first pass" metabolism in the liver and that their use may avoid potentially dangerous side effects of synthetic hormones used in conventional hormone therapy. However, studies to establish the long-term safety and effectiveness of these products have not been carried out.

Medications Other Than Estrogen

The class of drugs known as selective serotonin reuptake inhibitors (SSRIs) and selective norepinephrine reuptake inhibitors (SNRIs) typically used in the treatment of depression and anxiety, has been shown to be effective in reducing menopausal hot flashes. Paroxetine (Brisdelle) is an SSRI that has been approved for the treatment of moderate to severe hot flashed associated with menopause. Another SSRI that has been tested and shown to be effective is venlafaxine (Effexor), although other SSRI drugs may be effective as well.

Clonidine (Catapres) is a drug that decreases blood pressure. Clonidine can effectively relieve hot flashes in some women. Side effects include dry mouth, constipation, drowsiness, and difficulty sleeping.

Gabapentin (Neurontin), a drug primarily used for the treatment of seizures, has also been used successfully to treat hot flashes.

Progestin drugs have also been successfully used to treat hot flashes. Megestrol acetate (Megace) is sometimes prescribed over the short-term to help relieve hot flashes. Serious effects can occur if the medication is abruptly discontinued, and megestrol is not usually recommended as a first-line drug to treat hot flashes. An unpleasant side effect of Megestrol is that it may lead to weight gain.

Several medications may be used for preventing and treating osteoporosis.

  • The bisphosphonates, which include alendronate (Fosamax) and risedronate (Actonel), have been shown in clinical trials to reduce bone loss in postmenopausal women and to reduce fracture risk in women who have osteoporosis.
  • Raloxifene (Evista), a selective estrogen receptor modulator (SERM), is another therapy for osteoporosis. It reduces bone loss and appears to reduce the risk of back fractures in women with osteoporosis.
  • Calcitonin (Miacalcin or Calcimar) is a nasal spray that has been found to reduce the risk of back fractures in women who have osteoporosis.
  • A prevention drug that may also be effective is PTH (parathyroid hormone), but this is not a usual first-line treatment.
Medically Reviewed by a Doctor on 9/29/2015

Must Read Articles Related to Menopause

Female Sexual Problems
Female Sexual Problems Long considered a taboo subject, women's sexuality is now openly discussed and portrayed on television, in magazines, and on the internet. Symptoms of female se...learn more >>
Hot Flashes
Hot Flashes and Menopause Hot flashes are a common condition experienced by women in the perimenopause and menopause transition. The exact cause of the hot flashes is not clear. Symptoms...learn more >>
Pain During Intercourse
Pain During Intercourse Pain during intercourse (dyspareunia) is pain or discomfort in a woman's labial, vaginal, or pelvic areas during or after sexual intercourse. Pain during interc...learn more >>

Patient Comments & Reviews

The eMedicineHealth doctors ask about Menopause:

Menopause - Symptoms

What symptoms have you experienced with menopause?

Menopause - Experience

Please describe your experience with menopause.

Menopause - Hormone Therapy

What hormone therapy combination therapies have you taken during perimenopause, menopause, or post menopause?

Menopause - Experience

Please share your experience with perimenopause, menopause, or postmenopause.

Menopause - Symptoms

What symptoms did/do you have with perimenopause, menopause, or postmenopause?

Menopause - Lifestyle Changes

What lifestyle changes have you made during perimenopause, menopause, or postmenopause that have helped ease the symptoms?

Medical Dictionary