Table: Some Drugs Used to Treat Symptoms and Effects of Menopause

Some Drugs Used to Treat Symptoms and Effects of Menopause

Drug	Advantages	Disadvantages
Female hormones
*Estrogen therapy, with or without a progestogen	Relieves hot flashes, night sweats, vaginal dryness, and pain during intercourse Helps prevent osteoporosis and reduce the risk of bone fractures	Combination therapy (estrogen plus a progestogen): Increases the risk of blood clots in the legs Deep Vein Thrombosis (DVT) Deep vein thrombosis is the formation of blood clots (thrombi) in the deep veins, usually in the legs. Blood clots may form in veins if the vein is injured, a disorder causes the blood to clot... read more , blood clots in the lungs Pulmonary Embolism (PE) Pulmonary embolism is the blocking of an artery of the lung (pulmonary artery) by a collection of solid material brought through the bloodstream (embolus)—usually a blood clot (thrombus) or... read more , stroke Overview of Stroke A stroke occurs when an artery to the brain becomes blocked or ruptures, resulting in death of an area of brain tissue due to loss of its blood supply (cerebral infarction) and symptoms that... read more , gallbladder disorders Overview of Gallbladder and Bile Duct Disorders The liver produces bile, a greenish yellow, thick, sticky fluid. Bile aids digestion by making cholesterol, fats, and fat-soluble vitamins easier to absorb from the intestine. Bile also helps... read more (such as gallstones), and urinary incontinence Urinary Incontinence in Adults Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women... read more After 3–5 years of use, increases the risk of breast cancer Breast Cancer Breast cancer occurs when cells in the breast become abnormal and divide uncontrollably. Breast cancer usually starts in the glands that produce milk (lobules) or the tubes (ducts) that carry... read more very slightly If women are older when they start it, increases the risk of coronary artery disease Overview of Coronary Artery Disease (CAD) Coronary artery disease is a condition in which the blood supply to the heart muscle is partially or completely blocked. The heart muscle needs a constant supply of oxygen-rich blood. The coronary... read more and dementia Dementia Dementia is a slow, progressive decline in mental function including memory, thinking, judgment, and the ability to learn. Typically, symptoms include memory loss, problems using language and... read more Estrogen alone: Increases the risk of blood clots in the legs and lungs, stroke, gallbladder disorders, and urinary incontinence Increases the risk of endometrial cancer Cancer of the Uterus The most common type of cancer of the uterus develops in the lining of the uterus (endometrium) and is called endometrial cancer. Endometrial cancer usually affects women after menopause. It... read more (cancer of the lining of the uterus) May slightly increase the risk of breast cancer but probably not for many years With lower doses of estrogen and with estrogen given through a patch on the skin (transdermal form), apparently a lower risk of blood clots, stroke, and gallbladder disorders (such as gallstones) than with forms taken by mouth
A progestogen, such as medroxyprogesterone acetate or micronized progesterone (a natural rather than synthetic progesterone)	Reduces the risk of endometrial cancer, which is associated with taking estrogen alone Is not as effective as estrogen for relieving hot flashes	Does not relieve vaginal dryness May cause abdominal bloating, breast tenderness, increased breast density, mood disturbances, and/or headache Increases LDL (the bad) cholesterol levels May increase the risk of blood clots in the legs and lungs Has less clear effects on the risk of other disorders Micronized progesterone: May have a less negative effect on mood and LDL cholesterol than synthetic progestins May cause drowsiness (and so is usually taken at night) Appears to have fewer side effects than other progestogens
Selective estrogen receptor modulators (SERMs)
Ospemifene	Relieves pain during intercourse	May worsen hot flashes temporarily May increase the risk of blood clots in the legs and lungs
Conjugated estrogen plus bazedoxifene
Conjugated estrogen plus bazedoxifene (a SERM)	Relieves hot flashes, improves sleep, prevents bone loss, and lessens vaginal atrophy (thinning and drying of the vagina with loss of elasticity) Less breast tenderness and vaginal bleeding than with other forms of hormone therapy Does not appear to increase breast density or incidence of breast cancer Protects the uterus without the need for a progestogen	May increase the risk of blood clots in the legs and lungs
Antidepressants
Selective serotonin reuptake inhibitors Selective serotonin reuptake inhibitors (SSRIs) Agomelatine, a new type of antidepressant, is a possible treatment for major depressive episodes. Several types of drugs can be used to treat depression: Selective serotonin reuptake inhibitors... read more (SSRIs), such as desvenlafaxine, fluoxetine, sertraline, paroxetine in low doses (particularly), and sustained-release paroxetine Serotonin-norepinephrine reuptake inhibitors, such as venlafaxine	Relieve depression, anxiety, irritability, and insomnia Are somewhat effective for relieving hot flashes	Depending on the drug, can have side effects, such as sexual dysfunction, nausea, diarrhea, weight loss (in the short term), weight gain (in the long term), drowsiness (sedation), dry mouth, confusion, and increased or decreased blood pressure
Antiseizure drug (only one)
Gabapentin	Is somewhat effective for relieving hot flashes and may help relieve night sweats	Can have side effects, such as drowsiness, dizziness, headache, rash, weight gain, and leg swelling
* Determining whether the risk of certain disorders is increased by estrogen alone or by estrogen plus a progestogen (combination therapy) is difficult.
HDL = high-density lipoprotein; LDL = low-density lipoprotein.