About 75% of peri- and postmenopausal women have vasomotor symptoms, such as hot flashes and night sweats; however, some women experience more distress or "bother" in response to these symptoms. A new research study suggests that certain personality traits may affect how women experience these uncomfortable symptoms.
Many women transitioning into the menopause request medical advice on ways to improve their quality of life and to relieve the symptoms associated with the menopausal transition. With concerns regarding the long-term use of estrogen replacement therapy, there has been interest in the use of non-hormonal strategies to manage these symptoms.
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.
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 a recent study comparing hot flashes in 934 cancer survivors (90% of whom had breast cancer) and 155 age-matched control subjects who never had cancer, researches observed that cancer survivors reported more frequent, severe, and troubling hot flashes.
Studies assessing the effectiveness of complementary and alternative medicines (CAM) for the treatment of menopause-related hot flashes have yielded conflicting results. Most studies have demonstrated that treatments such as soy and black cohosh are not likely to be effective in most women; however, a new study suggests that women who take higher doses (100 to 200 mg)of isoflavones and more frequent dosing (2-3 times per day) may experience a greater reduction in the frequency of hot flashes.
Several studies have shown that gabapentin (Neurontin) at 600-2400 mg/day in divided doses is effective for treating hot flashes in menopausal women. Research presented at the annual meeting of the North American Menopause Society (NAMS) indicates that an investigational extended release (ER) formulation of gabapentin (Serada, Depomed) is effective for the treatment of hot flashes and sleep disturbance.
For decades, estrogen has been used to treat menopausal symptoms, including night sweats and hot flashes. However, after studies reported that estrogen increases the risk of cardiovascular disease and breast cancer, many patients and clinicians have looked into alternative treatments for hot flashes, including selective serotonin reuptake inhibitors (SSRIs).
Various studies have shown that women with a higher body mass index (BMI) or a higher percent of body fat have more frequent or more severe menopausal symptoms. In a recent study, researchers evaluated the impact of a low-fat diet on vasomotor symptoms in a group of 17,473 postmenopausal women between the ages of 50 and 79.
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.
