The diagnosis of menopause is usually clear, based on age and the menstrual history. Hormones levels can be evaluated, in particular follicle stimulating hormone (FSH), which increases as ovarian function decreases, however it is not diagnostic for menopause.
Postmenopausal woman should have regular evaluations for bone density and cardiovascular health.
Hormone Replacement therapy
Hormone replacement therapy (HRT) is the most common treatment for menopausal symptoms. The main pharmaceutical form is conjugated estrogens, with or with synthetic progesterone (progestins). Traditionally conjugated estrogens are obtained from pregnant horse’s urine, i.e. Premarin.
When conjugated estrogens are given alone there is an increased risk of endometrial (uterine) cancer, when given with progestin there is a slight decrease in the risk, but it does not go away.
Although it was originally thought that HRT reduced the risk for cardiovascular disease (stroke, heart attack, embolism, deep vein thrombosis), current research indicates it does not, and can increase the risk.
HRT should not be used for anybody with an active or past incidence of cancer, liver or gall bladder disease
HRT also increases the risk of other conditions such as gall bladder disease, migraine headaches, blood sugar problems and high cholesterol.
Natural Hormone Replacement Therapy
Natural hormone replacement therapy (NHRT), or bio-identical hormones, are natural based hormones made from plants. Natural hormone preparations can be individually prescribed and made by a compounding pharmacy. There is limited research using bio-identical hormones, but they have been used by health care practitioners with great success.
As the use of HRT becomes more dangerous, antidepressants are used with more frequency for women who suffer form insomnia and depression. In some cases antidepressants have helped with hot flashes. The main class of antidepressants used is selective serotonin reuptake inhibitors (Prozac and Aropax are examples). These medications have several side effects such as fatigues, rebound anxiety and sexual dysfunction.