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New Treatment Guidelines for Menopausal Symptoms Like VAGINAL ATROPHY

Illustration for article titled New Treatment Guidelines for Menopausal Symptoms Like VAGINAL ATROPHY

Hormone replacement therapy has been a really confusing topic for the past decade, with different studies offering conflicting information about its health benefits and consequences. Finally, the American Congress of Obstetricians and Gynecologists has revised its guidelines on treating the symptoms of menopause like hot flashes and vaginal atrophy (shudder).

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Issued as a practice bulletin for doctors, the document gives guidelines for the proper management of menopausal symptoms—which affect three-fourths of women once their bodies stop producing estrogen.

Hormone replacement was a common practice for years as a treatment for the symptoms—like hot flashes and vaginal atrophy—and was also considered to prolong life and reduce incidences of dementia. However, in 2002 a widely-reported study found that a popular hormone pill increased a woman's risk of heart disease, breast cancer, stroke and blood clots. It scared off many women from hormone replacement treatment, and helped spawn an industry of alternative treatments.

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The new guidelines help clear up the confusion. The ACOG advises that hormone replacement therapy be used, but consider transdermal (using a patch, gel, or spray) medication to be safer, since being absorbed through the skin means bypassing the liver, thus avoiding an increased risk of heart attack or cancer. However, the ACOG also recommends that hormone replacement therapy is not good for women over 65.

As far as alternative treatments go, the report said that low doses of antidepressants were helpful, as well as Clonidine (a blood pressure medication) and gabapentin (an anticonvulsant), though these have not been approved by the FDA for menopausal treatment. The report found "little to no data" supporting the use of herbal remedies, vitamins, soy, or acupuncture.

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DISCUSSION

Good heavens, why are you shouting the words "vaginal atrophy?" I understand that this sounds horrific to someone who is, perhaps, many years away from menopause, but all it means is that the tissues in the vaginal canal become dry and more fragile...it's not quite as if the whole thing shrinks up and goes away. How on earth are we going to get people to take womens' health issues seriously if we act all squeamish ourselves? Vaginas are not scary nasty dark yucky places. Just parts of a woman's body, affected by the aging process like every other part. Please - as a middle aged woman, I beg you - don't act as if my body is some horrible dysfunctional freak show.