1. SC300 Unit five Prof. Maureen Foley mfoley@kaplan.edu AIM: FoleyMaur

2. AGENDA 1)Menopause History Symptoms Treatments a) Lifestyle changes b) Prescription c) Non-prescription 2) Smoking and menopause 3) Soy and menopause 4) Q & A

3. HISTORY “Menopause is not a dangerous time or experience for the majority of women, any more than puberty is…” Dr. Andrew F. Currier, 1897 “…a large proportion of women go through menopause with scarcely a ripple and need no medical treatment whatsoever.” Dr. Emil Novak, 1922

4. SYMPTOMS AND EVALUATION Episodes of sweating or hot “flashes” Heart discomfort Sleep problems Depressive mood, irritability, or anxiety Physical or mental exhaustion Sexual problems Bladder problems Dryness of vagina, skin, or hair Joint or muscular discomfort

5. Come to Seminar prepared to discuss the case of your second cousin Tilly, a 53-year- old woman who comes to you concerned about menopause. What treatments exist for menopause and how safe and effective are they? What are some of the drawbacks to these treatments?

6. TREATMENTS: LIFESTYLE CHANGES What can I do? Image credit: Microsoft Clip Art

7. TREATMENTS: PRESCRIPTION Prescription MedicationProsCons Hormone therapy (local or systemic): estrogen, progestogen, or combinations Decreases hot flashes Relieves vaginal dryness Relieves some urinary symptoms Prevents osteoporosis Increased risk of developing breast and uterine cancers, heart disease, stroke, pulmonary embolism, dementia Low-dose antidepressantsDecreases hot flashes Relieves mood symptoms Side effects may include sexual dysfunction, headache, nausea, insomnia, or drowsiness, dry mouth, decreased appetite, or constipation Anti-seizure medicationsDecreases hot flashesSide effects may include fatigue, dizziness, rash, heart palpitations, swelling, and drowsiness, but generally decrease over time (weeks) Anti-hypertensive medications Decreases hot flashesUnpleasant side effects including dry mouth, drowsiness, or insomina are common BiophosphenatesPrevents or treats osteoporosisSide effects may include damage to the esophagus and muscle pain; long-term use can lead to brittle bones (quantity over quality) Selective estrogen receptor modulators Prevents or treats osteoporosisIncreased risk of blood clots, hot flashes, nausea, and leg cramps

8. TREATMENTS: NON-PRESCRIPTION Non-prescription treatment ProsCons Black cohoshDecreases hot flashes Relieves some mood symptoms Relieves vaginal dryness Decreases sleep disturbances Increases risk of liver problems Dong QuaiDecreases hot flashes Relieves some mood symptoms Relieves vaginal dryness Increases risk of bleeding complications Ginseng or GinkgoRelieves some mood symptoms Decreases sleep disturbances Appears to be nontoxic, both in the short-term and long-term, except in highly excessive doses Chaste BerryDecreases hot flashes Relieves some mood symptoms Appears to be nontoxic, both in the short-term and long-term, except in highly excessive doses Passion flowerRelieves some mood symptoms Decreases sleep disturbances Appears to be nontoxic, both in the short-term and long-term, except in highly excessive doses

9. SMOKING Image credit: Microsoft Clip Art If Tilly has been a smoker all her life, how might this alter her transition through menopause?

10. Do some research on your own to learn about why, among Japanese women, hot flashes are very rare. Why do you think this might be the case?

11. SOY Image credit: Microsoft Clip Art