A study to be published in an upcoming issue of Menopause suggests that stellate ganglion blockade (SGB) may be an effective option for women with vasomotor symptoms (VMS), including hot flashes and night sweats. SGB is used primarily for pain management and involves the injection of local anesthetic into the stellate ganglion, part of the sympathetic nerve system located in the neck.
As many as 30% of people suffering from depression do not respond to antidepressant treatment1. When treatment options are exhausted psychiatrists often turn to electroconvulsive therapy (ECT). An electric current is used to cause a brief seizure in the brain. Although this is a relatively safe method of treatment, impairments of both cognition and memory are potential side effects2.
Following the publication of the Women's Health Initiative report in 2002, there was a dramatic drop in the use of hormone-replacement therapy (HRT) due to concerns about increased risk of heart disease, breast cancer, and stroke. Since that time, various non-hormonal alternatives have been utilized for the treatment of menopausal symptoms, including gabapentin and various serotonin reuptake inhibitors.
Although we do not typically adjust the dosage of medications based on gender, there are certain medications which may have different pharmacokinetics and rates of metabolism in women versus men.
Sexual side effects may occur in 40% to 70% of patients treated with serotonin reuptake inhibitors (SRIs) and is a common reason for poor compliance with treatment and eventual discontinuation. When sexual side effects occur, they tend to emerge early, are persistent, and rarely resolve spontaneously. A new study, reviewed in Medscape, suggests that exercise may help to reduce sexual side effects:
The US Food and Drug Administration (FDA) has approved a novel estrogen-based drug for women for the treatment of moderate-to-severe vasomotor symptoms and osteoporosis associated with menopause. Duavee (Wyeth Pharmaceuticals) is a once-a-day tablet containing a combination of conjugated estrogens and bazedoxifene, an estrogen agonist/antagonist.
Several recent studies have examined the impact of various types of physical activity on menopausal symptoms, including hot flashes, night sweats, and sleep disturbance.
In an excellent and thoughtful review article, Kristina Deligiannidis and Marlene Freeman (from the MGH Center for Women’s Mental Health) summarize data on the efficacy of complementary and alternative medicine therapies for the treatment of perinatal depression. This is one of the most thorough reviews on CAM and provides thoughtful, evidence-based recommendations regarding the use of these treatments for women with perinatal depression. It is definitely worth tracking down a copy of this review, but if you can’t find it, here is a summary.
About 75% of women with regular menstrual cycles report unpleasant physical or psychological symptoms premenstrually. For the majority of women, these symptoms are mild and tolerable. However, some women have more severe and disabling symptoms, or premenstrual dysphoric disorder (PMDD). Several years ago, a large, multicenter trial of calcium supplementation found that calcium (600 mg twice a day) significantly reduced both the physical and emotional symptoms of PMS; however, it has not been clear whether calcium supplementation might be effective for more severe premenstrual symptoms or PMDD.
Approximately seventy percent of all women experience hot flashes and/or night sweats during the menopause transition (Stearns et al, 2002). Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes, but today many women are pursuing non-hormonal treatments, including over-the-counter complementary and alternative medicines (CAMs) for the treatment of these symptoms.Â
