Menopause and Estrogen Treatment
Frequently asked questions about treatment for menopause and estrogen treatment.
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 Frequently Asked Questions

What is menopause?

Cessation of menstrual periods.

What is the cause of menopause?

  • The woman runs out of eggs.
  • Estrogen production drops dramatically.
  • Menopause frequently is preceded by a few years of perimenopause.

What are the initial symptoms of perimenopause?

  • Menstrual cycles are frequently shorter.
  • Menstrual cycles are often irregular.
  • Many women will begin having hot flashes.

What are the initial symptoms of menopause?

  • Cessation of menstruation
  • Hot flashes
  • Irritability
  • Mood disturbances
  • Headache
  • Insomnia
  • Occasional depression

What symptoms occur a few years after the onset of menopause?

  • Vaginal dryness
  • Painful intercourse
  • Vaginal discharge
  • Leaking of urine with coughing, sneezing or lifting
  • Wrinkled, thin skin
  • Decreased peripheral sensitivity

What diseases could be associated with estrogen deficiency?

  • Osteoporosis is proven to be associated with estrogen deficiency.
  • The following diseases are probably caused by estrogen deficiency:
  • Heart disease
  • Colon cancer
  • Alzheimer’s disease
  • Possible
  • Macular degeneration
  • Cataracts

Does estrogen treatment increase the risk of breast cancer?

The answer to this question is complicated. Estrogen treatment decreases the risk of dying from breast cancer. However, estrogen treatment increases the risk of developing breast cancer.

Does estrogen treatment increase the risk of other health problems?

There is a minimal increase in the risk of blood clots.

Why does estrogen treatment increase life expectancy by two years?

Estrogen treatment reduces the risk of dying from heart disease, colon cancer, and breast cancer.

How does estrogen improve quality of life?

Estrogen treatment increases independent living by reducing nursing home admissions due to fractured hips, heart attacks, and Alzheimer’s disease; and improves sexual function and bladder control.

What are possible side effects of estrogen?

  • Breast tenderness
  • Vaginal bleeding in women with a uterus.
  • Bloating, especially with progestin treatment
  • Minimal risk of blood clots

What other drugs prevent Alzheimer’s disease?

Current recommendations include a combination of estrogen, vitamin E, and ibuprofen.

What other drugs prevent osteoporosis?

  • Bisphosphonates (i.e. Fosamax)
  • SERMS (i.e. Evista)

What are the advantages of bisphosphonates?

  • Very effective
  • No hormonal side effects
  • Increases effectiveness of estrogen or SERMS in combination

What are the problems with bisphosphonates?

  • No non-osteoporosis benefits
  • High rate of gastrointestinal irritation

What are the benefits of Evista?

    Reduces invasive breast cancer (in comparison to a placebo drug) by 75 percent

  • Reduces cholesterol
  • No vaginal bleeding or breast tenderness

What are the risks of Evista?

  • Minimal risk of blood clots
  • No long-term users
  • Unknown effect on heart, brain, colon, etc.
  • Mild increase in hot flashes
  • Leg cramps

What form of prevention of estrogen deficiency is best?

Women with estrogen deficiency symptoms should receive estrogen treatment. Women with uterus also should take progestin.

Postmenopausal women with few or no symptoms of estrogen deficiency should discuss treatment options with their physicians. Potential non-bone benefits of treatments should be considered. Estrogen appears to have the most positive benefits. Evista reduces breast cancer. Fosamax has no added non-bone benefits.

Micheal M. Miller, M. D.Michael M. Miller, M.D., is associate professor of obstetrics and gynecology and director of the Division of Reproductive Endocrinology-Infertility at the University of Arkansas for Medical Sciences.

 


Related Site
UAMS Department of Obstetrics and Gynecology:
http://www.uams.edu/obgyn/obgyn.htm


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