Serio discusses menopause

Serio discusses menopause

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Vincent Serio, MD, director of Medical Services answered questions via email regarding menopause.

Q. Have you seen an increase in complaints regarding menopause symptoms?

A. I think the university actually feels that the number of traditional age (18-24) students is increasing.  From 2010 to 2013, the number of students in the above 50 age group is stable at 4 percent.

So, to answer your question, no, I don’t feel like we are seeing more complaints directly related to menopause.

However –we have always, and probably have also seen a small increase in symptom complaints related to the Perimenopause, again the demographic in this group is stable at about 14 percent – age 35-49.  Most women start having some symptoms related to the decline in ovarian function in the late 30s-early 50s prior to the true menopause.

Q. What has been recommended?

A. During the perimenopause a low estrogen oral contraceptive “the pill” may help transitional symptoms; hot flashes, mood changes, and bleeding control.  For mood changes, an antidepressant can help, and also can help hot flashes.

Estrogen replacement therapy remains the treatment of choice for hot flashes.  We recommend it and start with the lowest dose that is effective and continue for up to four years.  Most experts are not concerned about using estrogen when really needed for symptoms, as long as routine screening for breast cancer is done and the lowest dose is used for the shortest time possible.

There are a number of alternative/complementary therapies advocated for hot flash relief –soy, black cohosh – but most evidence shows that they are no more effective than placebo.

Q. If you have seen an increase, by how much over say the past ten years?

A. Again, mostly have seen an increase in perimenopausal complaints, I’d say maybe 1-2 percent in the past ten years.

I think the number of people seeking treatment for menopausal symptoms, which has traditionally been estrogen therapy, has actually decreased in the past ten years probably due to the large study in the early 2000′s, Women’s Health Initiative, which showed some concern over an increase in breast cancer for women on estrogen.   During the first few years after the study – no one was on estrogen, but the standard has relaxed after more detailed study showed that estrogen can be used to treat hot flashes in low doses and for short periods without any increase in breast cancer.  We just don’t use it long term.

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