In: Nursing
Population based epidemiological studies of menopausal women have shown multiple symptoms the core symptoms being vasomotor, vaginal, insomnia,and mood.
vasomotor symptoms most bothersome symptom include Hot flush (where there is sudden onset of feeling of heat in face, neck and chest for some time), chills, anxiety and increased heart rate.
Behavioral therapy with clinical Hypnosis is effective in RCT trials, others include avoiding coffee, alcohol, tobacco, spicy foods, cool drinks.
Over the counter products such as soy, black cohosh, widely used, though not proven in RCT trials, also omega 3 fatty acids supplements showed no efficacy. while conjugated equine estrogen .625mg was effective.
Hormonal prescription medications.
systemic hormonal therapy.
oral or transdermal or high - dose vaginal estrogen therapy are useful in treating the symptoms of vasomotor symptoms, when combined with progesterone reduced the risk of endometrial carcinoma.
Contraindications are unexplained vaginal bleeding, liver dysfunction, deep vein thrombosis, blood clotting disorder, pulmonary thromboembolism, history of breast and endometrial cancer, stroke, TIA.
Bazedoxifene is used in case of women with breast tenderness, breast density or uterine bleeding with conventional therapy.
Low dose vaginal estrogen used for genitourinary symptoms including vaginal dryness and dyspareunia.
Ospemifene is used to treat genitourinary symptoms including vaginal dryness and dyspareunia, when oral preparation is preferred.
Insomnia treatment depends upon the clinical findings, continuous positive airway pressure is used for sleep apnea. Restless leg syndrome treated with dopamine agonists, gabapentin and opioids.
Adverse mood include depression, which can be treated with antidepressants such as selective serotonin reuptake inhibitors.
Thus these are the various ways in which menopausal symptoms are treated.