The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your health care provider if you need to take any special precautions. Use each of these medications as recommended by your health care provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your health care provider.
There are a number of prescription therapies available for treating menopause-related symptoms. The most common drug used for menopause is the hormone estrogen, which helps make up for the lower levels secreted by your ovaries at menopause.
Since each person is unique, a number of factors need to be considered before you make the decision to use hormone therapies, including your family and medical history. The results of recent studies on estrogen replacement therapy (ERT) and estrogen plus progestin (hormone replacement therapy or HRT) suggest that the risks of long-term hormone replacement therapy (> 3 years) outweigh the benefits for many women. Therefore, you need to discuss the pros and cons of treatment with your health care provider.
Estrogen replacement therapy (ERT) provides you with a fraction of the amount of estrogen that was produced by your ovaries before menopause. It helps reduce hot flashes and vaginal dryness and may reduce your risk of osteoporosis. Estrogen may be administered as an oral tablet, skin patch, injection, pellet placed under the skin, or as a vaginal cream, ring, or tablet. Recent scientifically strong studies now show that estrogen replacement therapy increases a woman's risk of heart disease, endometrial cancer, ovarian and breast cancers, blood clots, and stroke. In general, if you have cardiac risk factors or known cardiac disease, are or may be pregnant, have a history of breast cancer or other hormone-sensitive cancer, have unexplained bleeding from your uterus, or a history of blot clotting disorders, you should not be using ERT. You should also avoid ERT over the long term (more than one or two years). You should discuss the risks and benefits of ERT with your health care provider.
Possible side effects include:
Uterine bleeding
Enlargement of benign uterine tumors
Sore Breasts
Abdominal bloating
Nausea
Fluid retention
Headache, including migraine
Dizziness
Corneal changes in the eye
Increased risk of breast, ovarian and endometrial cancers
Increased risk of heart attacks and strokes
Increased risk of blood clots
Progestogen
If you choose ERT, the progesterone that your ovaries once produced must be replaced to reduce the increased risk of uterine cancer from taking ERT alone. Progesterone or progestin (synthetic progesterone) is available as replacement therapy. If you have had your uterus removed (hysterectomy), you are not at risk for uterine cancer and do not need to take progesterone with ERT.
Conjugated Equine Estrogens and Medroxyprogesterone Acetate (Premphase)
Oral, Continuous-Combined:
Conjugated Equine Estrogens and Medroxyprogesterone Acetate (Prempro)
Ethinyl Estradiol and Norethindrone Acetate (Femhrt)
17-Beta Estradiol and Norethindrone Acetate (Activella)
Oral, Intermittent-Combined:
17-Beta Estradiol and Norgestimate (Ortho-Prefest)
Skin Patch, Continuous Cycle
17-Beta-Estradiol and Norethindrone Acetate (CombiPatch)
Skin Patch, Continuous Combined
17-Beta-Estradiol and Norethindrone Acetate (CombiPatch)
When progesterone is taken with estrogen, it is called Hormone Replacement Therapy (HRT). Options for HRT include cyclic, continuous-cyclic, continuous-combined, and intermittent-combined.
Long-term HRT increases the risk of strokes, blood clots, heart attacks, ovarian, endometrial, and invasive breast cancers. Therefore, you and your health care provider should carefully discuss the risks and benefits.
Possible side effects include:
Uterine bleeding or “spotting”
Fluid retention
Sore breasts
Headache
Mood changes
Increased risk of endometrial, breast and ovarian cancers
Increased risk of heart attacks and strokes
Increased risk of blood clots
Androgen
Androgen Oral Tablet
Methyltestosterone and esterified estrogens (Estratest, Menogen)
Androgen is a hormone produced by both males and females. In women, the ovaries secrete androgen as testosterone and androstenedione. As you get older, your ovaries produce less androgen as well as less estrogen. As a result of less androgen, some women notice a decline in their sex drive. Androgen, which must be taken with estrogen, may help improve sex drive in some women.
Possible side effects* include:
Restlessness
Depression
Growth of facial and body hair
Acne
An enlarged clitoris
Increased muscle mass
A lowered voice
Increased cardiovascular risks
*These side effects often occur as the result of improper dosages of androgen
Bisphosphonates
Common names include:
Alendronate (Fosamax)
Risedronate (Actonel)
These non-hormonal medications are used to prevent or treat osteoporosis. These agents effectively reduce both bone loss and your risk of fractures. Alendronate may cause gastrointestinal problems and irritation of your esophagus.
Selective Estrogen Receptor Modulators (SERMs)
Common names include:
Raloxifene (Evista)
SERMs have some of the beneficial effects of estrogen, especially improved bone strength, but no increased risk of breast cancer or uterine bleeding. However, these medications tend to cause, rather than relieve, hot flashes and increase your risk of blood clots and gallstones.
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
Take them as directed, not more, not less, not at a different time.
Do not stop taking them without consulting your health care provider.
Don’t share them with anyone else.
Know what effects and side effects to expect, and report them to your health care provider.
If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.
Plan ahead for refills so you don’t run out.
Sources:
Mayo Foundation for Medical Education and Research
National Women's Health Resource Center
http://www.healthywomen.org/content.cfm?L1=3&L2=52&L3=2.0&SS=0
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
