Non-hormonal treatments for menopausal symptoms

Hickey, Martha; Szabo, Rebecca A; Hunter, Myra

doi:10.1136/bmj.j5101

Cited by 59 publications

(44 citation statements)

References 50 publications

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“…B. Kaffee, Alkohol, Nikotin, warme Raumtemperatur, scharfe Gewürze. Die Vermeidung dieser auslösenden Stressoren kann einigen Frauen helfen, VMS zu lindern [1,15].…”

Section: Spezifische Menopausale Beschwerden Ganzheitlich Behandeln Vunclassified

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Wechseljahresbeschwerden – Hormonmangel nach der gynäko-onkologischen Therapie

Almstedt¹,

Hasenburg²

2019

Frauenheilkunde up2date

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“…B. Kaffee, Alkohol, Nikotin, warme Raumtemperatur, scharfe Gewürze. Die Vermeidung dieser auslösenden Stressoren kann einigen Frauen helfen, VMS zu lindern [1,15].…”

Section: Spezifische Menopausale Beschwerden Ganzheitlich Behandeln Vunclassified

“…Der direkte Einfluss körperlicher Bewegung auf VMS ist wissenschaftlich nicht eindeutig belegt [15]. Eine durch Ernährungsumstellung bedingte Körpergewichtsreduktion um 10 % kann jedoch signifikant das Auftreten von milden VMS reduzieren [3].…”

Section: Spezifische Menopausale Beschwerden Ganzheitlich Behandeln Vunclassified

Wechseljahresbeschwerden – Hormonmangel nach der gynäko-onkologischen Therapie

Almstedt¹,

Hasenburg²

2019

Frauenheilkunde up2date

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“…Vasomotor symptoms may be treated effectively with selective serotonin reuptake inhibitors (citalopram, escitalopram, sertraline, fluoxetine, paroxetine), serotonin–noradrenaline reuptake inhibitors (venlafaxine, desvenlafaxine), clonidine and gabapentin 2 , 55 . Citalopram (10–20 mg daily) has been specifically examined in patients with breast cancer and has been shown to reduce the frequency of hot flushes, with study participants being followed up to a maximum of 7 weeks 56 .…”

Section: Management Optionsmentioning

confidence: 99%

“…Menopause‐specific sleep disturbance has received limited attention in trials of non‐hormonal therapies for menopausal symptoms in patients with cancer. In trials measuring vasomotor symptoms in healthy women, escitalopram, paroxetine, venlafaxine, desvenlafaxine and gabapentin have been shown to improve vasomotor functions and sleep 2 . However, adverse side effects of selective serotonin reuptake inhibitors and serotonin–noradrenaline reuptake inhibitors include somnolence and insomnia.…”

Section: Management Optionsmentioning

confidence: 99%

“…Natural menopause occurs at an average age of 51 years in women of Western origin 1 . Symptoms related to the endocrine changes at this time include vasomotor symptoms (hot flushes and night sweats), vulvovaginal symptoms (vulvovaginal dryness, itching and discomfort) and dyspareunia 2 . In addition, sleep disturbance also increases across the menopause transition; this may be secondary to vasomotor symptoms 3 .…”

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confidence: 99%

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Managing menopausal symptoms after cancer: an evidence‐based approach for primary care

Marino

McNamara

Hickey

2018

Medical Journal of Australia

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Summary Impaired ovarian function and menopausal symptoms are common after cancer treatment. Menopausal symptoms often occur at an earlier age in women with cancer, and may be more severe than in natural menopause; they may be the most persistent and troubling sequelae of cancer. A third of female patients with cancer report dissatisfaction with the quality and length of physician–patient discussions about reproductive health, including menopause. Systemic menopausal hormone therapy is the most effective treatment for menopausal symptoms, but it is not suitable for all patients after cancer — where it is unsuitable, alternative effective non‐hormonal treatments are available. Effective pharmacological agents available to treat vasomotor symptoms include selective serotonin reuptake inhibitors, serotonin–noradrenaline reuptake inhibitors, clonidine and gabapentin. There is increasing evidence supporting cognitive behavioural therapy for the treatment of vasomotor symptoms, in self‐help or group settings. Vaginal atrophy can be treated with vaginal (topical) oestrogen with minimal systemic absorption; topical vaginal lubricants may help with vaginal dryness and dyspareunia, with some evidence suggesting that silicone‐based products may be more effective than water‐based ones. Bone health may be impaired in post‐menopausal women with cancer or in cancer survivors, particularly in women with treatment‐related menopause or in women receiving anti‐oestrogen therapies; this should be managed in addition to menopausal symptoms. Primary care physicians should be aware of the troublesome and ongoing nature of menopausal symptoms after cancer, should discuss them with all patients after cancer treatment, and should consider treatment or referral to a specialist for appropriate management.

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