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Informatics in Pharmacy

Menopause

August 13, 2018 By Dr. G, PharmD

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Menopause is the cessation of menstrual periods for 1 year.  The average age for menopause is 52.

  • Estrogen:
    • Estrogen relieves genitourinary atrophy, vasomotor instability, reduces hip and vertebral fractures, relieves hot flashes which decreases insomnia and fatigue, stabilizes mood changes, improves sexual function.
    • Risks: cancer, especially when unopposed, CHD, bloating, headache, breast tenderness, increased blood clotting
    • Women with a uterus should not take unopposed estrogen.
  • Progesterone:
    • Decreases risks of estrogen-induced bleeding and carcinoma.
    • Risks: bloating, weight gain, irritability, and depression
  • Long-term use (from 1 to 5 years) of hormone therapy is not recommended.
    • Give the lowest dose for the shortest time.
    • Try topical for vasomotor symptoms first.  There isn’t much systemic absorption with topical.
  • SERMs: ospemifene: contraindications similar to estrogen (but only works for vaginal symptoms).  Add progestin if omen still has a uterus.
  • SSRIs: Good for vasomotor symptoms in high-risk patients
  • Conjugated estrogen and bazedoxifene: SERM plus estrogen, may be used with an intact uterus.
  • Clonidine, gabapentin, and pregabalin are sometimes used for symptomatic relief.

Filed Under: Women's Health

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020