Unfortunately, the majority of primary care providers lack a solid understanding of menopause, leading to countless women neglected, mistreated, misguided, and frustrated. Because of this, I wanted to provide broader education about non hormone treatment options for women suffering menopausal symptoms. My ultimate goal is to educate women so they can feel safe, respected, and comfortable living their best midlife!
What is menopause?
According to the clinician’s guide to menopause practice, “between the ages of 40-58, menopause marks an important stage in a women’s life. Characterized by changes in bleeding patterns, hormone levels, body composition and psychosocial well-being.”
Why do I prescribe non hormone medications for midlife vasomotor symptoms (hot flashes and night sweats)?
I usually prescribe non hormonal medications when there are known reactions to estrogen therapy, history of blood clots, or history of breast cancer. Or in some cases when the patient does not want to initiate hormone therapy for personal reasons.
The first non hormone medication I regularly prescribe is either Brisdelle or Paxil. They are both Selective Serotonin Reuptake Inhibitor (SSRI). Since serotonin is involved in mood, anxiety, and sleep, it will improve both your sleep and thermo-regulation. Unfortunately, Brisdelle is very expensive and usually not covered by most insurances. In this case, I prescribe Paxil at the lowest dosage 10 mg once a day.
The next medication is Gabapetin. Evidence shows that Gabapentin 300mg at bed time reduces hot flashes, decreases nerve pain, and induces sleepiness. This medication is extremely beneficial for patients with neuropathic pain (damaged nerves that cause stabbing, tingling or burning pain to extremities).
In others cases when the patient has high blood pressure, I will use Clonidine 0.1mg, an antihypertensive medication. This medication can reduce vasomotor symptoms (hot flashes) and reduce blood pressure at the same time.
Have questions about the medications listed above?
Talk to your primary care provider. If you don’t have a PCP, comment below or DM me your questions!
By: Dionys Fuster, APRN