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60% to 80% of women experience menopausal symptoms, most commonly hot flashes and vaginal dryness. Studies indicate that menopausal symptoms can last a decade or longer and that it affects many women in their 60s.
Although randomised clinical trials indicate that hormone therapy can be a safe and effective way to control most menopausal symptoms, it’s not right for everyone. Women who have endured breast cancer, other hormone-receptive cancers or severe cardiovascular diseases are unfortunately not candidates for hormone therapy. That said, we have many patients who prefer a non-hormone approach regardless of their medical history.
There are several alternative treatments that may help alleviate some of the most bothersome menopause symptoms that are not hormone related.
Managing Hot Flashes
Women who are overweight or obese tend to report greater discomfort from hot flashes and several studies have confirmed that losing weight helps lower the intensity of hot flashes. BioConnect has worked very hard to bring the world’s best weight-loss solutions to Barbados. Options include:
We have also partnered with Barbados’s best sports and lifestyle coaches who can help you take real steps towards a new you.
Cognitive-Behavioural Therapy and, to a lesser extent, clinical hypnosis have been shown to be effective in reducing hot flashes. There is also growing evidence that mindfulness-based stress reduction can reduce the severity of hot flashes. Meditation, relaxation, deep breathing, and yoga might be helpful for some people, but study results have been inconsistent; however, these approaches are not likely to be harmful and may have other benefits. Acupuncture has also not been proven to reduce hot flashes, although some people find them helpful (possibly due to a placebo effect).
Antidepressant Medication can play a significant role to treat hot flashes for people who cannot take estrogen:
- Selective serotonin receptor inhibitors (SSRIs) are the class of antidepressants used most commonly for treating hot flashes. A form of paroxetine (sample brand name: Brisdelle) is an SSRI and is the only non-hormone therapy that is specifically approved for hot flashes in the United States. This medication has been used for many years for treating depression but can be taken at a lower dose for hot flashes. This drug though has a strong limitation since it cannot be taken by women with breast cancer who are taking a drug called tamoxifen as it can interfere with it. Although not formally approved for hot flashes, other SSRIs such as citalopram (brand name: Celexa) or escitalopram (brand name: Lexapro) can also relieve patients from hot flashes to similar degrees as is seen with paroxetine.
- Other antidepressants that are similar to SSRIs such as venlafaxine (brand name: Effexor) and desvenlafaxine (brand name: Pristiq) also reduce hot flashes, but they tend to have more side effects than the SSRIs.
- Fluoxetine (brand name: Prozac) and Sertraline (brand name: Zoloft) do not work as well as the other antidepressants listed.
- Gabapentin (sample brand name: Neurontin) is a medication that was developed to treat seizures. It also relieves hot flashes in some people. It may be taken as a single bedtime dose (if hot flashes are most bothersome at night) or can also be taken during the daytime.
- Oxybutynin is a drug that is usually used to treat overactive bladder and urinary incontinence. It also has been demonstrated to be effective in treating hot flashes. The most bothersome side effect is dry mouth.
A number of herbal treatments have been promoted as a natural remedy for hot flashes. Many people use black cohosh for hot flashes, but clinical trials have shown that it is not more effective than a placebo. There have been concerns that black cohosh could stimulate breast tissue like estrogen, increasing the risk of recurrence in people who have had breast cancer. However, there is no convincing evidence that it is harmful, even in people with breast cancer. Still, some experts suggest that people with breast cancer avoid black cohosh until this has been studied more extensively. Herbal treatments in general are not recommended for hot flashes or other menopausal symptoms.
There is quite a bit of evidence that soy products can alleviate hot flashes but the degree of relief provided varies widely. There is early evidence that a 10-milligram S-equol supplement taken twice a day may control hot flashes with no harmful side effects. However, more studies are needed to better determine its effectiveness. Because of the effect on estrogen receptors, it is generally not recommended in women with a history of breast cancer.
Isoflavones and Phytoestrogens
These are present in various foods including soy, flax seeds, lentils and oats. The results of taking these as a supplement to improve menopausal symptoms are very varied and the risks of taking these are still unknown. They are generally not recommended in women with a history of breast cancer. They are natural, as well as BHRT, but still hormones!
Managing Genitourinary Syndrome During Menopause
Non-Hormone Treatments for Vaginal Dryness
Following menopause and the diminishing of estrogen and testosterone, vaginal tissues become thinner and drier which causes Genitourinary Syndrome of Menopause (GSM). The syndrome may include but is not limited to:
- Genital symptoms of dryness
- Burning, and irritation
- Sexual symptoms of lack of lubrication
- Discomfort or pain and impaired function
- Urinary symptoms such as incontinence, dysuria, and recurrent urinary tract infections.
BioConnect has invested millions of dollars in the latest state-of-the art technologies to make a real change in women’s lives. We believe in well-ageing.
Pelvic Floor Physical Treatment
Emsella is a device at BioConnect that strengthens the pelvic floor muscles while the patient sits fully clothed. Sessions tend to last 30min and after a bout of six treatments, our patients reported that their incontinence was gone for at least a year. Click here to learn more.
Vaginal Laser Treatment & Vaginal Care
MonaLisa Touch is a medical procedure at BioConnect that delivers fractional CO2 (carbon dioxide) laser energy to soft tissues such as the vaginal wall. This gentle laser treatment can regenerate your vaginal tissue safely and effectively. It provides you with a hormone-free, medication-free solution to a range of pelvic health conditions. Click here to learn more.
Vaginal lubricants are water-based or silicone-based liquids or gels that reduce friction during intercourse. Lubricants are not absorbed into the skin so don’t provide long-lasting relief though. They should be applied right before having sex.
Vaginal Moisturisers adhere to, or are absorbed by, vaginal tissue which means they provide longer-lasting relief from itching and pain than lubricants. Unlike lubricants, they are designed to be applied regularly to maintain a balanced level of moisture.
Antibiotics can also be used to treat UTIs
Cranberry supplements have been proven to give some sort of protection of the urogenital tract helping in the prevention of UTIs.
Finally, lifestyle changes:
- Decreasing alcohol consumption
- Targeted nutrition plans
- Counselling and coaching
- And a mix of the above to help support you during the menopause journey.