For decades, estrogen was used as a component of hormone replacement therapy to treat menopausal symptoms, including hot flashes, night sweats, and sleep disturbance; however, after several large, prospective studies (e.g., HERS, WHI) questioned the [...]
Because women appear to be at increased risk for new onset and recurrent depression as they transition into the menopause, it has been hypothesized that declining ovarian function -- or estrogen "withdrawal" -- may trigger [...]
Since the Women's Health Initiative (WHI) reported that the risks of menopausal hormone replacement therapy (HRT) outweighed its benefits, there has been a significant reduction in the use of HRT. Â However, since that time, studies [...]
Early observational studies suggested that postmenopausal hormone treatment may improve cognitive functioning in women; however, studies from the Women’s Health Initiative have shown that estrogen replacement therapy started in postmenopausal women (65 years or older) [...]
While there are concerns regarding the risks associated with prolonged use of hormone replacement, an increasing number of studies suggest that the risk may be relatively low in certain settings. A study presented this week at the Endocrine Society’s annual meeting which analyzed data from 43 randomized clinical trials suggests that menopausal hormone-replacement therapy does not appear to affect mortality either positively or negatively.
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.
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.
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.
We previously reported on studies suggesting estrogen may be helpful for the treatment of depression in peri- and post-menopausal women, either alone or in combination with an antidepressant. In addition, other studies have suggested that older, postmenopausal women may respond more poorly to antidepressants than premenopausal women. Two recent studies attempt to better understand the impact of reproductive hormones on clinical presentation and treatment response of depression in women.
The National Comorbidity Survey estimates that by the time women reach midlife, approximately 23% have experienced at least one episode of major depression and 30% have been diagnosed with an anxiety disorder. Depression and anxiety disorders are each associated with impaired functioning and lower quality of life (QOL). There is also some data to suggest that, even after a depressive episode resolves, those with a history of a affective illness have a lower quality of life than those without histories of depression, with impairment in social and interpersonal functioning.
