Joan Bengtson, MD

Q: I'm experiencing symptoms of menopause, including weight gain, short-term memory loss, irritability, confusion, night sweats, and exhaustion. What are my treatment options?

A: Menopause symptoms affect almost all women, but the duration and severity varies.

The "hot flash," a brief but uncomfortable sensation of warmth that spreads across the upper body and face, is the most common symptom. Sleep loss from hot flashes at night can cause mood swings and problems with clear thinking. Vaginal dryness and uncomfortable intercourse are other symptoms of menopause.

Menopause symptoms may last a few months to several years. If symptoms are mild and not disruptive, treatment is not necessary. If treatment is required, several options are available:

Lifestyle changes

-- Dress in layers that can easily be removed or added as needed.

-- Drink a glass of cool water at the start of a hot flash and keep drinking water throughout the day.

-- Avoid foods that trigger hot flashes (red wine, chocolate, and caffeinated drinks bother many women).

-- Exercise regularly.

-- Keep a regular schedule for sleep.

Treating vaginal dryness

-- Lubricating gels such as K-Y Jelly and Astroglide can treat dryness and make intercourse more comfortable.

-- Hormone creams and vaginal suppositories can be prescribed if lubricants do not work.

Medications for hot flashes

-- Estrogen is very effective but should be used in the lowest dose for the shortest time to minimize potentially serious risks.

-- Low dose antidepressants (such as venlafaxine, fluoxetine, and paroxetine) relieve hot flashes in about 60 percent of women.

-- Clonidine is usually used to treat high blood pressure, but is also effective for hot flashes in some women.

-- Gabapentin, a medicine originally used to treat seizures, has also been shown to be effective, but may cause drowsiness so it is often used at night.


Soy, herbal supplements (including black cohosh, evening primrose oil, and other over- the-counter products) may be tried, but studies have not shown them to be better than fake pills (placebos) for relieving menopause symptoms.

Joan Bengtson, M.D., is an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and Brigham and Women's Hospital, Boston, Mass. Dr. Bengtson is a Senior Medical Editor at Harvard Health Publications.)


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Health - Menopause Symptoms Vary in Duration and Severity