Vim & Vigor - Fall 2019 - GMC - 21

The most effective remedy is hormone replacement therapy, or HRT,
which refers to drugs containing
estrogen only or a mix of estrogen and
progesterone, or synthetic versions of
these hormones.
"HRT is the gold standard because it
reduces both the frequency and severity of the hot flashes," Pinkerton says.
Although not as effective as HRT,
low doses of selective serotonin reuptake inhibitor (SSRI) antidepressants,
as well as certain anti-seizure and
blood pressure medications, also have
been shown to help.
Rather than take medication, many
women opt for lifestyle changes, such
as wearing pajamas made from wicking fabric, using fans, lowering the
thermostat (65 to 68 degrees is the
ideal range at night) and limiting
triggers such as alcohol, spicy food
and caffeine.
Because anxiety can also lead to
feelings of being too hot, Pinkerton
suggests "mind-body approaches"
such as meditation, yoga, hypnosis and
cognitive behavioral therapy, a form
of psychotherapy. Smoking and being
overweight also increase the chances
of having hot flashes.

Vaginal Dryness

The first step to relief from vaginal dryness? Put aside any discomfort about
speaking openly with your doctor.
"Women are embarrassed to talk
about painful intercourse and providers are hesitant to ask about it,
and we need to stop that, because
there are many things that can help,"
Pinkerton says.
Along with drugstore lubricants,
women can try over-the-counter vaginal moisturizers, which are typically
applied two or three times a week.
Low-dose prescription vaginal estrogen therapies are also available, often
given as creams or tablets. Another
option is Intrarosa, a vaginal suppository that mimics the adrenal hormone

DHEA and is also being studied as a
treatment for decreased libido.
Finally, the hormone-free oral medication Osphena is known for its ability
to decrease vaginal discomfort.
Pinkerton cautions that those who
have had cancer may not be good candidates for any kind of hormone therapy.
"Low-dose hormones can be considered on an individual basis, but women
should always discuss their safest
options with their oncologist," she says.

"You can train the brain to find the
sleep cycle again," Pinkerton says.
Some women find over-the-counter
melatonin to be helpful, and HRT has,
as Pinkerton says, "been shown to
improve the amount of sleep women
get and increase the time spent in REM
[deep sleep] stages." She urges women
to avoid sedatives like Ambien, which
may become habit-forming. ■

Insomnia

The National Sleep Foundation recommends adults get at least seven hours of
sleep each night-and some people need
more. Getting sleep helps women deal
with mood swings, brain fog and other
cognitive issues.
"Adequate sleep not only helps with
mood and the ability to focus and concentrate, but it may also decrease the
dementia risk later in life," Pinkerton
says. Of course, many women dealing with perimenopause or menopause
symptoms report sleeping troubles,
often related to night sweats and
hot flashes.
Besides addressing issues related to
temperature and comfort, Pinkerton
suggests identifying your ideal bedtime
routine, performing it each night and
even repeating it if you wake up.

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4 Things to
Know About
Hormone
Therapy
The decision of whether to take hormones
isn't a simple one. "Not only is it a
controversial topic due to certain health
risks, but there are also numerous options
to pick from," says Sheila Warren, RN,
GMC's Wellness Navigator.
If you're considering hormone
replacement therapy (HRT), here are
key facts to know:
1. It's not for everyone. Doctors
advise those with a history of blood clots,
stroke, heart attack or cancer to avoid
HRT, as it may increase the chances for
these diseases to recur.
2. Treatment comes in many forms.
Pills are the most commonly prescribed.
For hot flashes, systemic medications can
be given as patches, sprays, gels or with
a vaginal ring. To combat vaginal dryness,
vaginal tablets, low-dose medications such
as vaginal suppositories and creams can
be used to moisturize and rebuild tissue.
3. The risks associated with HRT
increase with age. Women younger than
60 and within 10 years of menopause are
the ideal candidates for HRT, says Warren.
4. HRT can improve quality of life.
HRT has been shown to decrease hot
flashes and night sweats, prevent bone
loss, improve sleep and decrease anxiety.

FALL 2019

21
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Vim & Vigor - Fall 2019 - GMC

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