{"id":793,"date":"2017-01-23T14:32:02","date_gmt":"2017-01-23T12:32:02","guid":{"rendered":"http:\/\/womana.com.cy\/?page_id=793\/"},"modified":"2017-01-23T15:38:38","modified_gmt":"2017-01-23T13:38:38","slug":"treatment-menopausal-symptoms","status":"publish","type":"page","link":"https:\/\/www.womana.com.cy\/en\/guidelines\/treatment-menopausal-symptoms\/","title":{"rendered":"Treatment of menopausal symptoms"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_section-bffb7f23ecfaf21f208e15f338b79497\">\n.avia-section.av-av_section-bffb7f23ecfaf21f208e15f338b79497{\nbackground-repeat:no-repeat;\nbackground-image:url(https:\/\/www.womana.com.cy\/wp-content\/uploads\/2016\/12\/male-fertility-assessments.jpg);\nbackground-position:50% 50%;\nbackground-attachment:scroll;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section av-av_section-bffb7f23ecfaf21f208e15f338b79497 main_color avia-section-default avia-no-border-styling  avia-builder-el-0  el_before_av_section  avia-builder-el-first  avia-full-stretch avia-bg-style-scroll av-minimum-height av-minimum-height-25 av-height-25  container_wrap fullsize'  data-section-bg-repeat='stretch' data-av_minimum_height_pc='25' data-av_min_height_opt='25'><div class='container av-section-cont-open' ><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-793'><div class='entry-content-wrapper clearfix'>\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><div id='av_section_2'  class='avia-section av-av_section-3c1fdba40d338b16ca77c196ccce61e6 main_color avia-section-default avia-no-border-styling  avia-builder-el-1  el_after_av_section  avia-builder-el-last  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-793'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_three_fourth-6126cab7d8fab8d08143dd2dacdf673c\">\n.flex_column.av-av_three_fourth-6126cab7d8fab8d08143dd2dacdf673c{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_three_fourth-6126cab7d8fab8d08143dd2dacdf673c av_three_fourth  avia-builder-el-2  el_before_av_one_fourth  avia-builder-el-first  first flex_column_div av-zero-column-padding  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_heading-6f0aa450fc364b2ccc2185a6cfe02233\">\n#top .av-special-heading.av-av_heading-6f0aa450fc364b2ccc2185a6cfe02233{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-av_heading-6f0aa450fc364b2ccc2185a6cfe02233 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-av_heading-6f0aa450fc364b2ccc2185a6cfe02233 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-av_heading-6f0aa450fc364b2ccc2185a6cfe02233 av-special-heading-h1 blockquote modern-quote modern-centered  avia-builder-el-3  el_before_av_hr  avia-builder-el-first '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Treatment of menopausal symptoms<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><br \/>\n<div  class='hr av-av_hr-bad5bc90bcef2f12297bff634a297b07 hr-short  avia-builder-el-4  el_after_av_heading  el_before_av_textblock  hr-center'><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div><br \/>\n<section  class='av_textblock_section av-av_textblock-0366cc7376be6c9e82a3e9cc8987b64f '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p>Hormone-Replacement Therapy (HRT) for selected women at low risk for cardiovascular disease (CVD) and breast cancer and who are both bothered by their symptoms and are eager to take HRT.<\/p>\n<p>Women are eligible for HRT if they are under the age of 60 and are no more than 10 years into menopause. Physicians also need to assess a patient&#8217;s baseline risk for CVD or breast cancer \u2014 a high risk for either condition can constitute a contraindication to use of HRT. The evaluation of the risk is performed according to: Standard <a href=\"http:\/\/www.medscape.com\/viewarticle\/814206\">CVD risk-assessment scores<\/a> and for cancer, the <a href=\"http:\/\/www.cancer.gov\/bcrisktool\/\">National Cancer Institute Breast Cancer Risk Assessment Tool<\/a> by the <a href=\"http:\/\/www.ems-trials.org\/riskevaluator\/\">International Breast Intervention Study calculator<\/a>.<\/p>\n<p><strong>Vasomotor and Genitourinary Symptoms Warrant Intervention<\/strong><\/p>\n<p>Menopause symptoms frequently start in the years before the final menstrual period and can last, with unpredictable duration, from a few years to more than 13 years.<\/p>\n<p>The two main symptoms the Endocrine Society&#8217;s new guidelines specifically target are vasomotor symptoms (hot flushes\/flashes\/night sweats) and genitourinary symptoms (vaginal dryness or discharge, pain, burning or itching, urinary frequency, recurrent urinary tract infections).<\/p>\n<p>&#8220;The most effective therapy [for both sets of symptoms] is HRT,&#8221; Dr Stuenkel said.<\/p>\n<p>It is less clear whether anxiety, irritability, depression, palpitations, skin dryness, loss of libido, and fatigue can be attributed to menopause, the new guidelines state.<\/p>\n<p>Candidates for HRT can receive estrogen replacement alone if they are without a uterus;<\/p>\n<p>if women have a uterus, they require the combination of estrogen plus progestogen to prevent endometrial hyperplasia and cancer.<\/p>\n<p>Additional hormonal options for women with a uterus include estrogen combined with bazedoxifene and tibolone where available.<\/p>\n<p>Other medical options recommended by the Endocrine Society include:<\/p>\n<ul>\n<li>Transdermal estrogen therapy by patch, gel, or spray for women who want HRT but who have an increased risk of venous thromboembolism.<\/li>\n<li>Selective serotonin-reuptake inhibitors, serotonin\/norepinephrine-reuptake inhibitors, gabapentin, or pregabalin are recommended for women who want medication to manage moderate to severe hot flashes but who prefer either not to take HRT or have significant risk factors that make HRT inadvisable.<\/li>\n<li>Low-dose vaginal estrogen therapy may be used to treat genitourinary symptom, but even low-dose vaginal estrogen is relatively contraindicated in women with a history of an estrogen-dependent cancer.<\/li>\n<\/ul>\n<p><strong>Impact of Menopausal Symptoms &#8220;Substantial&#8221;<\/strong><\/p>\n<p>&#8220;The impact of severe menopausal symptoms on quality of life may be substantial,&#8221; Dr Stuenkel noted.<\/p>\n<p>In light of this, there are circumstances under which a woman with a history of coronary artery disease or even breast cancer might choose to accept a degree of risk that initially might outweigh the benefits of HRT.<\/p>\n<p><strong>Stopping HRT an Individual Choice, Too<\/strong><\/p>\n<p>The guidelines also state that the approach to discontinuation of HRT is an individual choice, too.<\/p>\n<p>Menopausal symptoms and joint pain can recur when HRT is discontinued, and, depending on the severity of the symptoms, women may elect to restart HRT, perhaps at a lower dose, or seek relief with nonhormonal therapies.<\/p>\n<p>&#8220;Anecdotally, some women find that a very low dose\u2026maintains adequate symptom relief and well-being and prefer that to complete discontinuation,&#8221; state the recommendations.<\/p>\n<p>Resources for patients are available at <a href=\"http:\/\/www.menopausemap.org\/\">www.menopausemap.org<\/a>. The <a href=\"http:\/\/www.hormone.org\/\">Hormone Health Network<\/a> also offers a digital toolkit for healthcare providers.<\/p>\n<\/div><\/section><br \/>\n<div  class='av_promobox av-av_promobox-67c1b8e9697bc6253e4fca0d3ed3c085 avia-button-yes  avia-builder-el-6  el_after_av_textblock  el_before_av_textblock '><div class='avia-promocontent'><p>\n<strong>Vasilios Tanos MD PhD,<\/strong><br \/>\nProfessor of Obstetrics and Gynecology, St. George&#8217;s Medical School at the University of Nicosia and Aretaeio Hospital in Nicosia<\/p>\n<\/div><div  class='avia-button-wrap av-av_button-56c0c563c33b74ca4940a3785deaea82-wrap avia-button-right '><a href='https:\/\/www.womana.com.cy\/en\/contact\/'  class='avia-button av-av_button-56c0c563c33b74ca4940a3785deaea82 av-link-btn avia-icon_select-yes-left-icon avia-size-large avia-position-right avia-color-theme-color'   aria-label=\"Contact\"><span class='avia_button_icon avia_button_icon_left avia-iconfont avia-font-entypo-fontello' data-av_icon='\ue805' data-av_iconfont='entypo-fontello' ><\/span><span class='avia_iconbox_title' >Contact<\/span><\/a><\/div><\/div><br \/>\n<section  class='av_textblock_section av-av_textblock-0366cc7376be6c9e82a3e9cc8987b64f '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p style=\"text-align: right;\"><a href=\"http:\/\/womana.com.cy\/en\/disclaimer\/\">Disclaimer<\/a><\/p>\n<\/div><\/section><\/p><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-av_one_fourth-586d5a7772599657b90ecdbdf66a14c1\">\n.flex_column.av-av_one_fourth-586d5a7772599657b90ecdbdf66a14c1{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-av_one_fourth-586d5a7772599657b90ecdbdf66a14c1 av_one_fourth  avia-builder-el-8  el_after_av_three_fourth  avia-builder-el-last  flex_column_div av-zero-column-padding  '     ><div  class='avia-builder-widget-area clearfix  avia-builder-el-9  avia-builder-el-no-sibling '><div id=\"nav_menu-5\" class=\"widget clearfix widget_nav_menu\"><h3 class=\"widgettitle\">\u039a\u03b1\u03c4\u03b5\u03c5\u03b8\u03c5\u03bd\u03c4\u03ae\u03c1\u03b9\u03b5\u03c2 \u039f\u03b4\u03b7\u03b3\u03af\u03b5\u03c2<\/h3><div class=\"menu-guidelines-en-container\"><ul id=\"menu-guidelines-en\" class=\"menu\"><li id=\"menu-item-834\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-834\"><a href=\"https:\/\/www.womana.com.cy\/en\/guidelines\/breast-cancer-screening\/\">Breast Cancer Screening<\/a><\/li>\n<li id=\"menu-item-835\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-835\"><a href=\"https:\/\/www.womana.com.cy\/en\/guidelines\/early-detection-cervical-cancer\/\">Early detection of cervical cancer<\/a><\/li>\n<li id=\"menu-item-836\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-836\"><a href=\"https:\/\/www.womana.com.cy\/en\/guidelines\/endometrial-intraepithelial-neoplasia\/\">Endometrial Intraepithelial Neoplasia<\/a><\/li>\n<li id=\"menu-item-837\" class=\"menu-item menu-item-type-post_type menu-item-object-page menu-item-837\"><a href=\"https:\/\/www.womana.com.cy\/en\/guidelines\/treatment-menopausal-symptoms\/\">Treatment of menopausal symptoms<\/a><\/li>\n<\/ul><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":742,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-793","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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