Q&A: Managing Menopause Symptoms Safely

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Q&A: Managing Menopause Symptoms Safely

Some smart alternatives to hormone therapy

Women who are abruptly thrown into menopause by chemotherapy often face a new set of challenges besides fighting cancer. Although hormone therapy can help relieve menopausal symptoms — such as hot flashes, irritability and insomnia — it may increase a woman's risk for breast cancer and possibly ovarian cancer.

Joanne Mortimer, M.D., medical oncologist and director of the Women's Cancers Program at City of Hope, explains the risks and offers ways to relieve the symptoms of menopause.

Why does hormone therapy increase cancer risk?

The study that showed a connection between cancer and the use of progesterone and estrogen during menopause created as many questions as it did answers, but the risk is real. We know that 75 percent of breast cancers are fed by estrogen, so it can be risky to put women on estrogen, especially if they've already had breast cancer.

Are there other options for women struggling with menopause symptoms?

Absolutely. Some people don't like the concept of being on antidepressants, but they really work for about one-third of women. They can help with sleep, temperature regulation like hot flashes and night sweats, mood problems and other symptoms. Another medication that can help is Neurontin (gabapentin), which is normally used for nerve pain.

Are there lifestyle changes that can help during menopause?

Exercise and diet are important, because menopause slows the metabolism and can cause weight gain. There's no evidence that diet and exercise reduce your risk of cancer, but overweight women don't respond as well to breast cancer treatment and are more likely to have recurrences. Exercise has been shown, in general, to improve mood and sleep.

What about bioidentical hormones, the drugs that mimic natural hormones?

There are no studies that say these are helpful — as much as I wish they were, because I sympathize with women going through menopause.

Are herbal remedies or supplements beneficial? And are they safe?

The only supplement proven to help some women is high-dose vitamin E. But other things, like soy and black cohosh, haven't shown any benefit in studies. Also, supplements aren't regulated like prescription medications, so you don't know if they might do harm.

Amy Lynn Smith

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