Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy. This choice can be especially difficult for women taking newer medications which lack adequate reproductive safety data. While we have [...]
Which treatment is best for managing menopausal sleep problems? We tend to think of estrogen replacement therapy as being the best option for all menopausal symptoms; however, there are other options for managing menopausal symptoms, [...]
A recent paper from the European Menopause and Andropause Society (EMAS) reviews non-hormonal therapy options for the treatment of menopausal vasomotor symptoms. This EMAS position paper provides guidance for treaters managing peri- and postmenopausal women [...]
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.
Selective serotonin reuptake inhibitor (SSRI) antidepressants may affect platelet aggregation and thus may increase the risk of bleeding. Several studies have sought to determine if exposure to SSRI antidepressants in late pregnancy is associated with an increased risk of postpartum hemorrhage.
For the treatment of menopausal vasomotor symptoms (VMS), such as hot flashes and night sweats, selective serotonin reuptake inhibitors (SSRIs) are effective and well-tolerated. Positive effects are observed within 4 weeks of the initiation of treatment. However, we do not know how long treatment with an SSRI must be continued in order to maintain control of VMS. Nor do we know if VMS will recur after discontinuation of SSRI or if recurrent VMS may be less frequent or less bothersome after receiving SSRI treatment. A recent report from Dr. Hadine Joffe and colleagues at the Center for Women’s Mental Health assessed the recurrence of vasomotor symptoms in women treated with SSRIs.
A substantial proportion of women transitioning into menopause experience a new onset or recurrence of depressive symptoms. A new study from the Center for Women’s Mental Health indicates that duloxetine (Cymbalta) is effective for the treatment of depression and may also have a beneficial effect on vasomotor symptoms (hot flashes and night sweats).
Selective serotonin and serotonin-norepinephrine inhibitors (SSRIs and SNRIs) have been shown to be effective for the treatment of hot flashes. However, these agents may carry certain side effects, including sexual side effects and sleep disturbance. These two side effects may be particularly concerning to peri- and postmenopausal women who, in addition to having vasomotor symptoms, are more likely to experience sexual dysfunction and sleep disruption than premenopausal women.
