The Menopause Book by Barbara Kantrowitz

Author:Barbara Kantrowitz
Language: eng
Format: epub
Publisher: Workman Publishing Company
Published: 2018-03-21T04:00:00+00:00

Antidepressants Alone

Q. Will antidepressants help my hot flashes even if I don’t have any mood problems? I’m scared to take hormones, but I’d like to find relief!

A. They may. The original studies on antidepressants and hot flashes were part of an effort to find something that would reduce hot flashes in women who were recovering from breast cancer. Because of the link between estrogen and some breast tumors, hormone therapy is not an option in many such cases. Since the antidepressants Effexor, Paxil, Lexapro, Celexa, and Pristiq work for many of these women, doctors assume that the same is true for women who have not had breast cancer.

Like many other drugs, antidepressants can have unpleasant side effects, so you’ll have to decide whether or not the benefits are worth it for you. You might also want to consider nondrug alternatives. We offer lots of ideas in Chapter 3.

Flashes and Bipolar Disorder

Q. I have a history of bipolar disorder. Can I use hormone therapy for my severe hot flashes?

A. Estrogen may reduce depression but it may also induce mania, so the role of hormone therapy for bipolar women isn’t clear. While research continues, talk to your doctor about your specific risks.

What About Tibolone?

Q. Some of my European friends use a drug called tibolone that’s supposed to be good for mood, hot flashes, and bones. Can I buy it in the United States?

A. The FDA rejected the new drug application submitted by the manufacturer of tibolone in 2006, after research associated its use with an increased risk of stroke. As a result, the company withdrew its application for entry into the U.S. market. It seems to share some of the properties of estrogen, progesterone, and testosterone and may help with mood and bone health. It may also reduce hot flashes and boost sex drive. It’s not a perfect drug, however. Early indications are that it lowers HDL (the good cholesterol), and there is significant concern about its effect on heart disease. In the British Million Women’s Study, tibolone also appeared to increase the risk of breast cancer. Tibolone has been available in Europe since 1988 and is available in most other countries.

Other Mental Health Issues

It’s more than normal worrying. Your heart starts pounding, you feel like you can’t breathe, and you begin to sweat all over. You have a sense of something terrible happening—even though everything is actually pretty normal.

What’s going on? These are symptoms of an anxiety disorder, probably caused by a biochemical imbalance that sets off a “fight or flight” response.

Generalized anxiety disorder. You have persistent feelings of anxiety that aren’t prompted by a specific event or concern. These can be intense as well as moderate and sometimes include panic attacks.

Panic attacks. These acute and overwhelming episodes of anxiety seem to come out of nowhere and include physical symptoms like rapid heartbeat, shortness of breath, dizziness, and trembling. They may be triggered by stressful situations and too much caffeine or other stimulants.

Panic disorder. Often referred to as a fear of

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