1 / 25

Managing Menopause

Managing Menopause. Beverly M. Vaughn, M.D. Clinical Assist. Prof. Ob/Gyn Thomas Jefferson University. Some Definitions.

efuru
Télécharger la présentation

Managing Menopause

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Managing Menopause Beverly M. Vaughn, M.D. Clinical Assist. Prof. Ob/Gyn Thomas Jefferson University

  2. Some Definitions • Perimenopause: The time before the final menstrual period characterized by irregular periods. Some women experience hot flashes, difficulty sleeping, and/or changes in mood. • Menopause: Begins 12 months after the final period

  3. How do I know if I’m menopausal? • Are hormonal levels useful? • Will I become menopausal after chemo and/or radiation therapy? • What happens if I have my ovaries removed?

  4. Every woman’s perimenopause and menopause is unique.

  5. Healthcare Provider Concerns • Cardiovascular disease • Cancer prevention • Osteoporosis • Obesity • Symptoms of menopause

  6. Patient Concerns • Hot flashes • Vaginal dryness • Libido • Poor sleep • Mood changes • Weight gain • Memory problems • Osteoporosis • Cancer prevention

  7. What’s happening to my body? • Cardiovascular changes: Shifts in HDL and LDL, decreased elasticity of blood vessels, increased formation of plaque • Musculoskeletal: Muscle converts to fat, decrease muscle strength, decrease in calcium absorption from the intestine, increase bone turnover resulting in decrease bone density • Weight gain: hormonal influence, caloric requirements decrease

  8. What’s happening to my body? • Skin: increased dryness, thinner skin, decreased collagen • Genitourinary: decreased blood flow, elasticity, and ability to retain moisture, thinner tissue, shorter vaginal canal, painful intercourse, possible increased susceptibility to bladder infections, increased incontinence

  9. What’s happening to my body? • Sexuality: Diminished perception of touch, changes in body image, prolonged arousal time, less intense orgasms, changes in libido

  10. What’s happening to my body? • Mood: Increased depression and moodiness occurs in the perimenopausal period

  11. Who manages my menopause symptoms?

  12. Hot flashes • Can occur with natural, surgical or chemotherapy induced menopause • Removal of the ovaries will cause immediate menopause but not necessarily immediate symptoms • Tamoxifen™, Arimidex™, Femara™ all cause hot flashes

  13. What about estrogen therapy?

  14. Controversial • Does the hormone receptor status matter? • Does the length of time since diagnosis matter? • Does age matter? • * Will it effect my risk of recurrence?*

  15. What about progesterone/progestin? • Synthetic progestins were used very effectively in the past. Their use is currently controversial.

  16. Bioidenticals • Bioidenticals are exogenous hormones biochemically similar to those produced endogenously by the body or ovaries

  17. Lifestyle changes • Avoid common triggers: alcohol, caffeine, cigarettes, hot and/or spicy foods, stress • Eat well, eat less and exercise • Dress in layers • Use natural fibers

  18. Non pharmaceutical therapies • Paced breathing • Relaxation therapy • Soy • Herbs ( i.e. black cohosh, red clover, flaxseed) • Vitamin E • Acupuncture

  19. Selective Serotonin Reuptake Inhibitors (SSRI’s) • Paxil ™, Prozac™, Effexor™, Celexa™, Lexapro™ • Works at the thermoregulatory center of the brain • Effective • Relief occurs quickly • Side effects

  20. Other pharmacologic options • Gabapentin ™ , Clonidine™ • Effectiveness • Side effects

  21. Vaginal dryness • Over the counter lubricants such as, K-Y™, Astroglide™, Slippery Stuff™, silicone products • Over the counter moisturizers like Replens™ • Almond oil • Vaginal estrogen ring, tablet or cream • Dilators • Patience, non intercourse intimacy

  22. Libido

  23. Libido • Vulnerability • Body image • Painful sex • Fatigue • Duration of relationship • Effect of hormones • Difficulty with arousal and achieving orgasm

  24. Libido • Look at all of the factors • Testosterone?????????? • Viagra™??????????

  25. Resources • www.soulsource.com • www.vaginismus.com • www.passionparties.com • www.middlesexmd.com • www.menopause.org • www.mainlinehealth.org/whs

More Related