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What alternative options or non-hormonal treatments are available for menopausal hormone therapy?

Not all women are good candidates for estrogen therapy. Women with breast cancer, for example, should not take postmenopausal hormone therapy because the health risks outweigh the potential benefits. If you fall into this category – non-hormonal treatments are available at Somi Javaid M.D. & Associates.

Although alternative treatments for menopause may not be as effective as estrogen, they still can provide relief from the bothersome symptoms associated with menopause. Here are a few options we can discuss with you:

  • Brisdelle: Bridelle, or the drug Paroxetine, is prescribed in low doses to treat hot flashes. 
  • Phytoestrogens: Phytoestrogens are chemical compounds derived plants and similar in structure to estrogen. They are found in soybeans, chickpeas, lentils, flax seed, grains, fruits, vegetables and red clover. Phytoestrogens work by replacing natural estrogen that your body makes less of during menopause. Isoflavone is one type of phytoestrogen that can be purchased from a health food store and taken as a supplement. It’s important to note that because some phytoestrogens can act like estrogen in parts of the body, women with breast cancer or a history of breast cancer are advised to avoid them.  
    • Black Cohash: Black Cohash is an herb that many women use to alleviate hot flashes. In clinical studies however black cohash has not been proven effective. Many herbal treatments have safety concerns and are therefore not optimal for treating hot flashes or any other menopausal symptoms. Dr. Somi Javaid will help you determine which treatment option is safest to try.
  • Moisturizers and Lubricants: A variety of topical medicines can be applied to effectively treat mild to moderate vaginal dryness, which is common to menopause. There are over the counter non-medicated products to choose from as well as more effective prescription-only medicines containing estrogen. If these do not improve your symptoms or if you have severe vaginal dryness, visit Dr. Somi Javaid to rule out causes other than menopause. Since thin and / or dry vaginal tissue leads to pain during intercourse consider both moisturizers and lubricants to lessen friction during sexual activity.
    • Lubricants: Lubricants are a good option for those menopausal women whose vaginal dryness is only a problem during sex. Either liquids or gels, lubricants are not absorbed into the skin, yet they provide immediate relief. Lubricants are safe to be applied to the vagina, the vulva, or to a penis.
      • Water-based lubricants: Water-based lubricants are safe, effective and non-staining. Here are a few to try: Astroglide, Femglide, Just Like ME, K-Y Jelly, Pre-seed, Slippery Stuff, Summer’s Eve. 
      • Oil-based Lubricants: Oil-based lubricants should be avoided because they can cause irritation and can actually break down condoms, potentially leading to a host of other problems. Examples of oil-based lubricants include petroleum jelly, baby oil, mineral oil, and Elegance Women’s Lubricant.
      • Silicone-based lubricants: Silicone-based lubricants are safe to use. A few to try are: ID Millennium, Pink, Pour, and Pure Pleasure
    • Moisturizers: Moisturizers are different from lubricants in that they are absorbed into the skin and coat the vaginal lining. Since the affects can last up to 3-4 days moisturizers are applied at regular intervals rather than just prior to intercourse. For some women the best results are obtained from an application of moisturizer every four days plus an application of lubricant before intercourse. Some moisturizers to try are Fresh Start, K-Y Silk-E, Moist Again, Replens, K-Y Liquibeads.
  • Probiotics: A healthy digestive tract is imperative for our immunity, emotional wellness and hormone health, especially during menopause. As we age the microflora in our gut changes Our beneficial bacteria, Lactobacillus and Bifidobacteria, declines and therefore weakens our immune system. This makes way for more problems with digestion and absorbtion and eventually throws off our delicate hormone balance. Probiotics help to metabolize and recycle hormonal balance, help to reduce estrogen dominance and reduce the risk of osteoporosis. How? Probiotic supplements increase the good bacteria in our gut and reduce something called betaglucuromidase. This reduction of betaglucuronidase is a good thing because excess glucuronidase in the body is associated with a higher absorption of fat soluble toxins and an increased risk of estrogen dependent breast cancer. When choosing supplements look for the highest number of live microbes per dose, preferably 10 billion CFU / dose. What is a CFU?
  • Lifestyle Changes and Stress Management: Cortisol, the stress hormone, and menopause are related. Estrogen naturally limits the amount of cortisol that our bodies produce. As estrogen declines with menopause our organs, muscles and bones are negatively affected by an increase in cortisol. In this way stress and cortisol can exacerbate menopausal symptoms and a viscous cycle can take over. Thankfully there are certain lifestyle strategies to keep cortisol in check and preserve hormonal balance.
  1. We can fine tune our diets by making higher nutritional quality choices.
  2. We can improve our exercise habits, seeking help if necessary. 
  3. We can try to find a creative outlet we enjoy for mental and spiritual wellness.
  4. We can develop better sleep habits and be sure to put REST on our schedule. 
  5. We can try to participate in regular meaningful social interaction, and put FUN on our schedule. 
  6. We can make time for self care, like a manicure or a pedicure. 
  • Other lifestyle practices that can be highly beneficial:
    • Yoga Studies show that yoga is good for stress reduction, relaxation, increased energy, and relief from both insomnia and hot flashes typically associated with menopause. The practice of yoga increases blood flow to our hormone making organs and glands. Simply stated, this increased blood flow leads to better overall health and wellness. Deep breathing and mediation can also provide some relief. Try These Yoga Poses For Menopause Relief
    • Massage Massage works similarly to yoga to reduce stress and facilitate relaxation while experiencing menopause. With massage, a therapist may employ our body’s natural reflex action to promote healing and offer relief from menopausal symptoms. Since our body partsare interconnected via nerve pathways, a massage therapist can increase blood flow to certain parts of the body and other areas of the body will benefit. This is often called trigger point therapy. Other types of massage therapy to try for menopausal relief are: myofacial release, Swedish massage, shiatsu, reflexology.  How do I find a licensed massage therapist near me?  Be prepared to answer questions about why you want massage therapy and about your health history. 
    • Accupuncture Accupuncture is a 2500 year old form of Chinese medicine that involves the use of many fine, metallic, sterile needles. Acupuncture can relieve menopausal symptoms by inserting these needles into the skin at very specific locations on the body, called acupuncture points or meridians. This in turn elevates estradiol levels in the body and lessens the bothersome symptoms. Many women find accupuncture to be an effective, non-hormonal solution.