الفهرس 
MenopauseOnly 14 pages are availabe for public view
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Abstract
Menopause is “medicalized” in contemporary societies. There is great need to develop and disseminate information that emphasizes menopause as a normal, healthy phase of women’s lives and promotes its demedicalization. Medical care and future clinical trials are best focused on women with the most severe and prolonged symptoms. Numerous reports in the medical literature and popular media have discussed the effectiveness of various nonhormonal agents in reducing menopausal hot flash symptoms. Selective serotonin reuptake inhibitors and venlafaxine have been shown to reduce hot flashes by 19 to 60 percent and were well tolerated by study participants. Soy isoflavones reduced hot flashes by 9 to 40 percent in some trials, but most trials showed no difference compared with placebo. Other agents that have been used to alleviate hot flashes include gabapentin, mirtazapine, trazodone, vitamin E, and wild yam. Osteoporosis can be effectively treated when recognized by bisphosphonates, selective estrogen receptor modulator (SERM), raloxifene (Evista), calcitonin, parathyroid hormone, and by lifestyle and dietary changes. Recognizing and reducing the risk of heart disease is possible by treatment of risk factors and by life style modification. Reviewing the results, the investigators have recommended against the routine use of combined estrogen and progestin for the prevention of chronic conditions (CVD and osteoporosis) in postmenopausal women. The only indication is moderate to severe hot flushs and urogenital symptoms. Health care providers were advised to prescribe estrogen and combined estrogen with progestin drug products at the lowest dose and for the shortest duration for the individual woman.
Key words
(Menopause, nonhormonal treatment, hot flashes, osteoporosis, heart disease, low dose hormone therapy).