Menopause Handout 2024 PDF

MENOPAUSE Kalumi Ayala, Pharm.D., AAHIVP, TTS Clinical Assistant Professor, Pharmacy Practice Department 1 2 3 Describe the risk/benefits of treatment of menopausal symptoms Identify alternative options for the management of menopausal symptoms Design an appropriate treatment regimen for symptomatic...

MENOPAUSE Kalumi Ayala, Pharm.D., AAHIVP, TTS Clinical Assistant Professor, Pharmacy Practice Department 1 2 3 Describe the risk/benefits of treatment of menopausal symptoms Identify alternative options for the management of menopausal symptoms Design an appropriate treatment regimen for symptomatic postmenopausal women LECTURE OBJECTIVES MENOPAUSE Permanent cessation of menses  No menstrual period for 12 months Onset age usually around 51 years Clinical Presentation:  Vasomotor symptoms: Hot flashes/flushes, night sweats  Psychological symptoms: Anxiety, depression  Genitourinary syndrome: genital dryness, burning, irritation, impaired sexual function, vaginal atrophy  Others: sleep disturbance, joint pain, or headache This Photo by Unknown Author is licensed under CC BY-NC-ND MENOPAUSE TREATMENT Goals of therapy Relieve symptoms Improve quality of life Minimize medication adverse effects General treatment approach: Individualized treatment based on symptoms, quality of life goals, medical, social and family history. NON-PHARMACOLOGIC RECOMMENDATIONS Healthy Diet Exercise Weight Loss Smoking Cessation Avoid triggers Stay cool MENOPAUSE TREATMENT Pharmacologic therapy Hormone Replacement Therapy (HRT)  Estrogen (oral, transdermal, vaginal, intravaginal)  Progestin (oral)  Combination estrogen+ progestin (oral, transdermal) Selective Estrogen Receptor Modulators (SERMs)  Ospemifene (Osphena®)  Bazedoxifene, in combination with conjugated estrogen (Duavee®) Non-hormonal therapy  SSRIs  Paroxetine (Brisdelle®) MENOPAUSE TREATMENT Hormone Replacement Therapy (HRT) Rationale  Most effective therapy for management of vasomotor symptoms  Improves other menopause symptoms  Lowest dose should be used for shortest duration (