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Boggio Family of Pharmacies

Boggios: A healthy choice for your whole life

Symptoms of menopause can be very uncomfortable.  The three most common complaints are hot flashes, insomnia, and vaginal dryness.  After the Women’s Health Initiative trial many patients discontinued their hormone therapy due to concerns about cardiovascular problems and breast cancer with Premarin and Premplus.  Unfortunately this left many women struggling with their symptoms.

Mort recent guidelines have emphasized that short-term use of hormone therapy during early menopause may not be that risky.  The risk of heart disease is small if hormones are taken within the first 10 years of menopause.  Also, evidence indicates that the risk of breast cancer probably doesn’t increase when combination hormone therapy is used for only 2 to 3 years.  (Of course you should consult your doctor for their opinion on this information).

There are other options if patients do not want to go the traditional route of hormone replacement.  The best way to deal with symptoms is to treat them individually.

For patients with hot flashes try non drug options first.  Patients should exercise, manage their weight, stop smoking and avoid hot drinks, caffeine and alcohol.  There are some herbal products on the market that can be tried, but in general do not have much evidence for effectiveness.  Black cohosh is being used by many women but it does not seem any better than placebo for hot flashes.  In addition there have been some reports of liver toxicity with its use.  Soy may provide a small benefit.  A common dose is 60 grams /day of soy protein from food, or up to 120 mg/day of soy isoflavones from supplements.  Evening primrose, dong quai, wild yam, and red clover, chasteberry and ginseng have not been shown to work for hot flashes.   There are some prescription drugs that can be tried as well.  These include venlafaxine, gabapentin, and clonidine.  You can ask your doctor if one of these agents are right for you.

Vaginal dryness can be treated by an over the counter product called Replens.  If this proves ineffective a local estrogen therapy such as Vagifem can be tried.

Insomnia can be treated with a low dose non addictive prescription medication such as Zopiclone. An over the counter medication like Gravol or Benadryl can also be used on an occasional basis.

Osteoporosis is a real concern for menopausal women not on hormone therapy.  Women of this age should make sure they are getting 1500 mg of calcium and 1000 IU of vitamin D daily.

Bio-identical Hormone Replacement is another option for symptom treatment.  Hormones used in this treatment are identical to those in the human body.  Bio-identical Hormone therapy is very individualized treatment.  Patients have their hormones analyzed through a saliva test and then their prescriptions are tailor made to meet their needs.  Doses and hormones used are compounded in the pharmacy for each individual depending on their deficiencies and physician’s prescription.  For further information on this type of treatment please visit our website

Menopause can be an extremely difficult time for many women.  Luckily there are some good treatment options for the most bothersome symptoms.  The best approach to dealing with them is to consult your doctor and pharmacist about the safest most effective treatment for you.


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