Does The Vivelle Patch Cause Weight Gain

Does The Vivelle Patch Cause Weight Gain' title='Does The Vivelle Patch Cause Weight Gain' />Endocrinology Topics Paul Fitzgerald, M. D. MENOPAUSE HORMONE REPLACEMENT THERAPY HRTAttitudes towards post menopausal HRT continue to change. Along with its needed effects, estradiol the active ingredient contained in Oestrogel may cause some unwanted effects. Although not all of these side effects may. Does The Vivelle Patch Cause Weight Gain' title='Does The Vivelle Patch Cause Weight Gain' />Ive told my story about my experience with anxiety and insomnia a few times here on the blog and heres a post describing my favorite resources for overcoming. Continued Estrogen Treatment Skin Patches. What are they Skin patches are another type of ERT. Examples are Alora, Climara, Estraderm, and VivelleDot. EstrogenProestrogenScalesChart-1-650x349.jpg' alt='Does The Vivelle Patch Cause Weight Gain' title='Does The Vivelle Patch Cause Weight Gain' />Oral HRT enjoyed widespread use through the 1. Then came the Womens Health Initiative WHI, a prospective study of HRT that eventually enrolled 1. In 2. 00. 2, the WHI stopped the combined oral HRT arm of the study daily oral conjugated equine estrogen 0. In 2. 00. 4, the WHI stopped the oral estrogen only HRT arm of the study daily oral conjugated equine estrogen 0. Does The Vivelle Patch Cause Weight Gain' title='Does The Vivelle Patch Cause Weight Gain' />With such risks of oral HRT established, the use of postmenopausal estrogen replacement dropped dramatically. But things have changed. Since the WHI, there has been a monumental advance in HRT namely, transdermal estradiol preparations have been developed that do not increase the risk of coronary heart disease, pulmonary embolism, or stroke in fact, use of transdermal estradiol in the first 1. Transdermal estradiol can also dramatically improve many other symptoms that are described below. Additionally, breast cancer risk is not increased with low dose estrogen replacement, using a progestin just intermittently or not at all. The decision about using HRT must be individualized. Each woman and her health care provider should be well informed about HRTs potential benefits vs risks and the variety of preparations available. In this section, I will discuss Menopause HRT  1 Menopausal Symptoms 2 Menopause Laboratory Diagnosis  3 HRT Benefits vs Risks  4 HRT Medications comprehensive list  5 Menopause references from peer reviewed journals searchable. This information in also found in my chapter entitled Endocrine Disorders in the medical textbook Current Medical Diagnosis Treatment, published internationally by Mc. Graw Hill. Menopause Symptoms and Signs Vasomotor symptoms hot flushes are experienced by 6. Hot flushes can begin during the climacteric, years before menstrual periods cease they can continue well into a womans 6. The duration of hot flushes can vary from seconds to many minutes. Women experience heat, particularly around the upper body, including the head, neck, chest, and back. The severity can vary from mild to debilitating and many women experience drenching nocturnal sweats. Hot flushes peak in early menopause and then usually decline gradually over a median of 1. African American women tend to experience more severe hot flushes. Asian women are less affected. Obese women tend to have more severe hot flushes than do women at ideal body weight. Lower socio economic status also predisposes women to more severe hot flushes, for unknown reasons. Smokers tend to experience worse symptoms. Mild cognitive impairment commonly occurs at menopause. Maui Meta 3G Imei Repair. Depression irritability are common during menopause. The relationship between menopause and emotional lability is often not recognized, such that many women are prescribed antidepressants when the real problem is estrogen deficiency. Sleep disturbances are very common and lack of sleep may cause daytime fatigue and predispose to the cognitive impairment noted above. Fatigueis common during menopause, and may be aggravated by sleep disturbances noted above. Joint pains arthralgias are sometimes so severe in menopause that some women often seek help from rheumatologists who usually prescribe NSAIDS and may not recognize that the arthralgias are caused by estrogen deficiency. Diminished libidois commonly experienced at menopause. Headaches may become more frequent after menopause. Postmenopausal osteoporosis with fracturesis caused in large part by estradiol deficiency. The skin becomes more wrinkled. Atherosclerosis risk is increased. Estradiol deficiency typically increases LDL bad cholesterol and reduces HDL good cholesterol. Vulvovaginal atrophyis common after menopause, with symptoms of vaginal dryness, painful intercourse, and irritation. A careful pelvic examination is useful to check for uterine or adnexal enlargement and to obtain a Papanicolaou smear and a vaginal smear for assessment of estrogen effect. Vulvovaginal complaints are not always due to estrogen deficiency and direct inspection of the vulva is necessary to detect other conditions, such as lichen sclerosis, contact dermatitis, squamous hyperplasia, or malignancy. Menopause Laboratory Findings Early Menopause lt age 4. Elevated serum or urine h. CG overwhelmingly indicates pregnancy. Further laboratory evaluation for women who are not pregnant includes serum estradiol PRL, FSH, LH, and TSH. Hyperprolactinemia or hypopituitarism without obvious cause should prompt an MRI study of the pituitary and hypothalamus. Routine testing of kidney and liver function BUN, serum creatinine, bilirubin, alkaline phosphatase, and alanine aminotransferase is also performed. A serum testosterone level is obtained in hirsute or virilized women. Patients with manifestations of hypercortisolism Cushing syndrome receive a 1 mg overnight dexamethasone suppression test for initial screening. Nonpregnant women without any laboratory abnormality may receive a 1. Normal Menopause  No laboratory testing is required to diagnose menopause, when amenorrhea occurs at the expected age. The expected age of menopause correlates with a womans mothers age at menopause and varies among different kindreds and ethnic groups. An elevated serum FSH with a low or low normal serum estradiol helps confirm the diagnosis. Menopause Treatment Nonhormonal Medical Therapy. Hot flushes may be reduced with low room temperatures, dressing coolly, and consuming cold beverages. Night sweats may be reduced by sleeping in a cool room and by avoiding the use of excessively warm blankets or down comforters. Slow, deep breathing can ameliorate hot flushes. Women may try avoiding known triggers for hot flushes, such as smoking, alcohol, caffeine, and hot spicy foods. Idiosyncratic triggers for hot flushes may be discerned and avoided. Aerobic training for 5. Clinical hypnosis reduced hot flushes over 1. Acupuncture may help alleviate symptoms in some women. For women with severe hot flushes who cannot take estrogen, SSRIs may offer modest relief effective within a week escitalopram 1. Venlafaxine extended release 7. Sexual dysfunction has not been less of a problem with the latter drugs when used for vasomotor symptoms, compared to their use for depression. Gabapentin is also quite effective in oral doses titrated up to 2. Side effects such as drowsiness, fatigue, dizziness, and headache, which are most pronounced during the first 2 weeks of therapy, often improve within 4 weeks. An herb, black cohosh, may possibly relieve hot flushes. Replens is a vaginal lubricant that can be used daily or 2 hours prior to intercourse. It improves vaginal moisture and elasticity and reduces vaginal irritation and dyspareunia. Hormone Replacement Therapy HRTEstrogen replacement is most commonly prescribed for women in early menopause, when symptoms are worst and the benefits are greatest. Transdermal estrogen is favored over oral therapy to reduce the risk of thromboembolism. In women with an intact uterus, estrogen replacement without a progestin risks endometrial hypertrophy and dysfunctional uterine bleeding. The addition of an oral progestin, however, increases the risk of breast cancer. Therefore, only the smallest effective dose of estrogen should be used in order to reduce the need for progestins in such women.