History along with signs and symptoms are sufficient to diagnose menopause and no tests are usually required. However, in certain circumstances your doctor may ask you to undergo certain lab tests such as estrogen and FSH (follicle stimulating hormone) and TSH (thyroid stimulating hormone). During menopause follicle stimulating hormone level increases and estrogen level decreases, which help in confirming diagnosis, if there is any doubt from history and signs and symptoms. TSH level is checked sometimes, because hypothyroidism (an underactive thyroid) can also cause similar symptoms like menopause.
Various treatment options for menopause:
Menopause is a normal/natural physiological process and in most cases requires no treatment, other than reassurance. However, in some cases, treatment may be required and it is mainly aimed at relieving signs and symptoms of menopause. Treatment options include,
- Hormone replacement therapy (HRT): the most effective way to manage signs and symptoms of menopause is hormone therapy. Use of estrogen is highly effective in treating menopausal hot flashes. If you have intact uterus, you may also need progestin in addition to estrogen. Estrogen have some additional benefits too, such as reducing bone loss (post menopause), and benefit in heart problems, especially if started within five years after last menstrual period.
- Local estrogen in vagina to prevent dryness of vagina. It can be used as estrogen vaginal cream, tablet or ring. This local treatment lead to release of small amount of estrogen locally in the vagina and act locally and reduce vaginal dryness and help relieve urinary symptoms and pain during intercourse.
- Certain antidepressants in low dose may be required in management of menopausal symptoms. SSRIs (selective serotonin reuptake inhibitors) are commonly used for treating menopausal hot flashes. These are also preferred for women who cannot take estrogen for medical reason.
- In addition to treat signs and symptoms of menopause, osteoporosis is also common problem after menopause and postmenopausal women also need treatment for osteoporosis.
- Gabapentin, a drug used for treatment of seizure is also useful in treating hot flashes. This can be used in women who cannot take estrogen for any medical condition and also suffer from migraine. It is beneficial for such patients.
It is important to have a clear idea what menopause is, before deciding which treatment option is best for you. You should discuss with your doctor regarding your problem. Your doctor can help you decide which treatment option is best for you.
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