If 50 really is the new 30, then some thanks must go to the drugs that help ease the transition into midlife. These medications can protect you from debilitating conditions like bone loss and heart disease and make life bearable for those with severe symptoms of menopause. But it's important to remember that many of the drugs must be taken for years and they do have side effects. Laura DeFina, MD, a staff physician at the Cooper Clinic in Dallas who focuses on healthy aging, helps sort out what you need to know, and what you need to ask your doctor.

Hormone Therapy

Why You Would Want Treatment:
By supplementing low levels of hormones, these drugs can relieve the worst symptoms of menopause, including hot flashes, night sweats, bone loss, and vaginal dryness. Estrogen/progestin pills can raise levels of hormones in the blood. Estradiol drugs (Estrace, Climara) are sometimes called bioidenticals; this synthetic hormone is chemically identical to estrogen made by a woman's ovaries (other bioidenticals may not be approved by the FDA).

Immediate side effects can include breast pain, vaginal bleeding (if you experience this, get evaluated for uterine cancer), fluid retention, and headaches. Long-term problems can involve (to varying degrees) increased risk of breast cancer, blood clots, heart disease, and stroke. Bisphosphonates may cause stomach upset, ulcers, bone, joint, and muscle pain, headaches, and, rarely, jaw osteoporosis. SERMs can trigger hot flashes, leg cramps or swelling, blood clots, and flu-like symptoms.

Ask Your Doctor:
...what she thinks about starting with short-term therapy (typically two to three years with annual reassessments) on the lowest possible dose you can tolerate. Also, ask her how this might affect your risk of cancer. 


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