Medications for Menopause & Mood Swings

Menopause is a normal part of a woman's life, not a disease. Medical treatment is necessary only for women whose symptoms become uncomfortable or severe. Before beginning any treatment regimen, meet with your primary health care practitioner or gynecologist to get a full check-up and to confirm that you are indeed experiencing menopausal symptoms. At this point, your doctor may prescribe medication to help manage negative symptoms of menopause.

• Menopause is part of every woman's life

Medications Used During Menopause

• Are Pills the Answer?

  Common medications that are used to treat negative menopausal symptoms include estrogen and hormone replacement therapy, bioidentical hormone therapy, antidepressants, high blood pressure medication and anti-seizure medication.

  Various non-traditional medications, herbs, vitamins, and other supplements are used in conjunction with or as alternatives to prescription medications.

Estrogen & Hormone Replacement Therapy

• Hormone Replacement Therapies

  Until recently, many women were started on estrogen replacement therapy or hormone replacement therapy (a combination of estrogen and progesterone). The long-term NIH-sponsored Women's Health Initiative (WHI) research project presented evidence that there are serious risks for long term hormone and estrogen replacement therapies. Replacing hormones may help reduce some of the symptoms and side effects such as hot flashes and vaginal dryness caused by a woman's altered chemical balance, but evidence from the WHI study "points to increased risk of developing heart disease, endometrial cancer, ovarian and breast cancers, blood clots, and stroke."

  In response to the findings of the WHI Project, many women and health care practitioners now believe that the risks of long term hormone therapy outweigh the benefits. If hormone therapy is chosen as an option, it should be used at the lowest effective dose for the shortest period of time. For example, some doctors are now recommending locally applied remedies like "low-dose vaginal estrogen (cream, tablet or ring) [which] reduces vaginal and urethral dryness ... without introducing high levels of estrogen into the body."

Mood Swings, Depression & Antidepressants

• Depression

  Some characteristics of depression and mood swings experienced by some, but not all, women during the stages of menopause include: a decreased interest in life, fatigue, insomnia, loss of appetite, hopelessness and thoughts of suicide. Some women also experience anxiety symptoms such as increased heart rate, difficulty breathing and feelings of being out of control.

  Antidepressant medications may be prescribed to help correct imbalances caused by fluctuating serotonin levels. Most of the commonly prescribed antidepressants such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa) and venlafaxine (Effexor), a drug related to the selective serotonin reuptake inhibitors (SSRIs), work by regulating a woman's serotonin levels and enhancing the availability of serotonin. Antidepressants are most effective when used in conjunction with counseling or psychotherapy. Some antidepressants also relieve hot flashes.

Hot Flashes

• There are prescription medications that provide some relief for hot flashes, although their specific purpose is not the treatment of hot flashes. Medications such as gabapentin (Neurontin) an antiseizure drug, and clonidine (Catapres), a drug used to treat high blood pressure, have provided some women with relief from hot flashes. All of these drugs have side effects, and women should discuss with their doctors the pros and cons of using them. Women who do decide to take these drugs to alleviate hot flashes should be monitored carefully.

  SSRIs have also been shown to help control hot flashes in up to 60% of women. However, some antidepressant medications are associated with side effects, such as decreased libido or sexual dysfunction.

Natural Supplements

• Supplements

  Some women prefer to rely on non-prescription supplements to alleviate negative symptoms of menopause, but opinions are mixed as to whether or not these supplements really help. Soy products, Vitamin E, and Black Cohosh are some of the commonly used "natural supplements" women use to manage menopausal symptoms such as bone loss, hot flashes and mood swings. Some studies, such as one conducted by Health Canada in 2006, have suggested there may be some risks associated with the use of certain natural supplements

  If a woman decides to try an alternative medicine or herbal remedy, she should make sure to discuss it with her health care provider. Even though these products are natural or herbal, they are still capable of causing unpleasant or even dangerous side effects.