Can Wellbutrin (bupropion) effectively treat menopausal hot flashes. What does the pilot study reveal about bupropion’s impact on hot flash frequency and severity. How does bupropion’s mechanism of action relate to hot flash pathophysiology. Why might bupropion not be recommended for further investigation as a hot flash remedy.

Understanding Bupropion and Its Potential for Hot Flash Relief

Bupropion, commonly known by its brand name Wellbutrin, is a medication primarily used for treating depression and nicotine dependence. Its unique properties have sparked interest in its potential application for managing menopausal hot flashes. Unlike many antidepressants, bupropion doesn’t typically cause sexual dysfunction, weight gain, or sedation, making it an attractive option for research into alternative hot flash treatments.

The efficacy of newer antidepressants in reducing hot flashes, coupled with anecdotal evidence of hot flash resolution in patients taking bupropion for smoking cessation, prompted researchers to investigate its potential as a hot flash remedy. This pilot study aimed to explore bupropion’s clinical activity in alleviating this common and often distressing symptom of menopause.

Why Consider Bupropion for Hot Flashes?

• Favorable side effect profile compared to other antidepressants
• Promising results from other antidepressants in hot flash management
• Anecdotal evidence of hot flash relief in patients using bupropion for other purposes

Pilot Study Design and Methodology

The pilot evaluation of bupropion for hot flash treatment was conducted between January 1999 and October 2004. The study enrolled 21 participants, consisting of 7 men and 14 women, to assess the medication’s effectiveness in reducing hot flash frequency and severity.

Key Aspects of the Study Protocol:

1. Participants documented their hot flashes using self-completed daily diaries
2. Baseline data was collected during week 1 (pre-treatment)
3. Treatment period spanned weeks 2 through 5
4. Bupropion dosage: 150 mg every morning for the first 3 days, then 150 mg twice daily for 4 weeks

The use of self-reported diaries allowed researchers to gather detailed information on the frequency and severity of hot flashes experienced by participants throughout the study period. This method provided valuable insights into the potential effects of bupropion on this menopausal symptom.

Study Results and Participant Outcomes

The pilot study’s results revealed several important findings regarding bupropion’s efficacy in treating hot flashes:

• One woman was excluded from analysis due to lack of hot flash information
• Five women discontinued the study due to side effects
• No significant reduction in hot flash frequency or severity was observed compared to expected placebo effects

Despite the small sample size, these results provide valuable insights into bupropion’s potential (or lack thereof) as a hot flash treatment. The study’s outcome aligns with current understanding of hot flash pathophysiology and bupropion’s mechanism of action, suggesting that this medication may not be an effective solution for menopausal hot flashes.

What Do These Results Imply?

The study’s findings indicate that bupropion may not be a promising candidate for hot flash relief. The lack of significant improvement in hot flash symptoms, combined with the occurrence of side effects in some participants, suggests that further investigation of bupropion as a hot flash remedy may not be warranted.

Bupropion’s Mechanism of Action and Hot Flash Pathophysiology

Understanding the relationship between bupropion’s mechanism of action and the current hypotheses regarding hot flash pathophysiology is crucial in interpreting the study results.

Bupropion’s Primary Effects:

• Norepinephrine reuptake inhibition
• Lack of significant serotonergic effects

Current Understanding of Hot Flash Pathophysiology:

• Increased noradrenergic activity
• Decreased serotonergic activity

The mismatch between bupropion’s effects and the underlying mechanisms of hot flashes may explain why the medication failed to demonstrate significant efficacy in this study. While bupropion inhibits norepinephrine reuptake, potentially exacerbating the increased noradrenergic activity associated with hot flashes, it does not address the decreased serotonergic activity that is also believed to play a role in this menopausal symptom.

Implications for Future Research and Treatment Options

The results of this pilot study have important implications for both future research directions and clinical practice in managing menopausal hot flashes:

Research Implications:

• Suggests that further investigation of bupropion for hot flash treatment may not be productive
• Highlights the importance of considering both noradrenergic and serotonergic mechanisms in hot flash interventions
• Emphasizes the need for continued exploration of alternative treatments that address the complex pathophysiology of hot flashes

Clinical Practice Implications:

• Indicates that bupropion may not be a recommended option for patients seeking relief from menopausal hot flashes
• Underscores the importance of considering medications that target both noradrenergic and serotonergic systems when managing hot flashes
• Highlights the need for individualized treatment approaches, as responses to hot flash interventions can vary among patients

While this study suggests that bupropion may not be an effective treatment for hot flashes, it contributes valuable information to the ongoing search for safe and effective management strategies for this common menopausal symptom.

Comparing Bupropion to Other Antidepressants in Hot Flash Treatment

The results of this pilot study on bupropion contrast with findings from studies on other antidepressants used for hot flash management. Some selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) have shown promise in reducing hot flash frequency and severity.

Antidepressants with Positive Results in Hot Flash Treatment:

• Venlafaxine (SNRI)
• Paroxetine (SSRI)
• Fluoxetine (SSRI)

The efficacy of these medications in managing hot flashes may be attributed to their effects on both serotonergic and noradrenergic systems. This dual action appears to be more aligned with the current understanding of hot flash pathophysiology, potentially explaining their greater success compared to bupropion.

Why Might Other Antidepressants Be More Effective?

1. Balanced impact on both serotonin and norepinephrine levels
2. Potential modulation of the thermoregulatory center in the hypothalamus
3. Possible influence on other neurotransmitters involved in hot flash mechanisms

The contrasting results between bupropion and other antidepressants in hot flash treatment highlight the complexity of this menopausal symptom and the importance of targeting multiple neurotransmitter systems for effective relief.

Exploring Alternative Non-Hormonal Treatments for Hot Flashes

Given the limitations of bupropion in treating hot flashes, as demonstrated by this pilot study, it’s important to consider alternative non-hormonal options for managing this menopausal symptom. While hormone replacement therapy remains an effective treatment for many women, some may prefer or require non-hormonal approaches.

Promising Non-Hormonal Treatments for Hot Flashes:

• Gabapentin (an anticonvulsant)
• Clonidine (an antihypertensive)
• Oxybutynin (an anticholinergic)
• Cognitive behavioral therapy
• Acupuncture
• Lifestyle modifications (e.g., avoiding triggers, dressing in layers)

These alternatives offer a range of options for women seeking relief from hot flashes, particularly those who cannot or choose not to use hormone therapy or certain antidepressants. The effectiveness of these treatments can vary among individuals, emphasizing the need for personalized approaches to hot flash management.

Factors to Consider When Choosing Hot Flash Treatments:

1. Individual medical history and risk factors
2. Severity and frequency of hot flashes
3. Presence of other menopausal symptoms
4. Personal preferences and lifestyle considerations
5. Potential side effects and interactions with other medications

As research in this field continues, new and innovative approaches to managing hot flashes may emerge, offering hope for improved quality of life for those affected by this common menopausal symptom.

The Future of Hot Flash Research and Treatment

While the pilot study on bupropion did not yield positive results for hot flash treatment, it contributes to the broader understanding of menopausal symptom management. The field of hot flash research continues to evolve, with ongoing efforts to develop more effective and tailored interventions.

Emerging Areas of Hot Flash Research:

• Neurokinin B receptor antagonists
• Novel cooling technologies
• Phytoestrogens and herbal remedies
• Mindfulness-based interventions
• Personalized medicine approaches based on genetic profiles

These areas of research hold promise for developing new treatments that may offer relief to those who do not respond well to current options or prefer alternative approaches. As our understanding of the complex mechanisms underlying hot flashes improves, so too does the potential for more targeted and effective interventions.

How Might Future Hot Flash Treatments Differ?

1. Greater specificity in targeting the neurochemical pathways involved in hot flashes
2. Increased focus on individualized treatment plans based on genetic and physiological factors
3. Integration of technological solutions with pharmacological and non-pharmacological approaches
4. Enhanced understanding of the interplay between hot flashes and other menopausal symptoms
5. Development of treatments with improved safety profiles and fewer side effects

As research progresses, the management of hot flashes and other menopausal symptoms is likely to become more sophisticated and tailored to individual needs. This evolution in treatment approaches offers hope for improved quality of life for those experiencing the challenges of menopause.

Pilot evaluation of bupropion for the treatment of hot flashes

. 2006 Jun;9(3):631-7.

doi: 10.1089/jpm.2006.9.631.

Domingo G Pérez 
¹
, Charles L Loprinzi, Jeff Sloan, Paul Novotny, Debra Barton, Lisa Carpenter, Deanne Smith, Brad Christensen, Teresa Rummans

Affiliations

Affiliation

• ¹ Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

• PMID:

  16752968

• DOI:

  10.1089/jpm.2006.9.631

Domingo G Pérez et al.

J Palliat Med.

2006 Jun.

. 2006 Jun;9(3):631-7.

doi: 10.1089/jpm.2006.9.631.

Authors

Domingo G Pérez 
¹
, Charles L Loprinzi, Jeff Sloan, Paul Novotny, Debra Barton, Lisa Carpenter, Deanne Smith, Brad Christensen, Teresa Rummans

Affiliation

• ¹ Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

• PMID:

  16752968

• DOI:

  10.1089/jpm.2006.9.631

Abstract

Bupropion is commonly used in the treatment of nicotine dependence and depression, and in most people, does not cause sexual dysfunction, weight gain, or sedation. Given its attractive side effect profile, the efficacy of other newer antidepressants against hot flashes and anecdotal observations of resolution of hot flashes in some patients taking bupropion for nicotine dependence, it was decided to explore its clinical activity as a hot flash remedy in a pilot study. Between January 1999 and October 2004, 21 patients (7 men and 14 women) were enrolled in the study. Self-completed daily hot flash diaries were used to document the frequency and severity of hot flashes at baseline (week 1) and during the treatment period (weeks 2 through 5). Participants received bupropion 150 mg every morning for the first 3 days and then 150 mg twice per day for a total of 4 weeks. One woman did not provide any hot flash information and was excluded from the analysis. Five women could not complete the study because of side effects. The study did not show a reduction in hot flash frequency and/or severity significantly higher than what would be expected with a placebo. Even though the sample size was small, these results are consistent with bupropion’s mechanism of action (norepinephrine reuptake inhibition without serotonergic effects) and what it is now hypothesized about the pathophysiology of hot flashes (increased noradrenergic activity and decreased serotonergic activity). These data suggest that bupropion should not be further investigated as a remedy for hot flashes.

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MeSH terms

Substances

Depression, Mood Swings, Anxiety, Sexual Side Effects of Menopause

Menopause and mood disorders. Few scientific studies support the idea that menopause contributes to true clinical depression, severe anxiety, or erratic behavior. Most women make the transition into menopause without experiencing a major mood disorder.

At the same time, hormone fluctuations, life stresses, sleep troubled by night sweats, and concerns about body image, infertility, and aging can all cause emotional distress that may lead to mood swings or, in more severe cases, depression. Many women report symptoms of depressed mood, stress, anxiety, and a decreased sense of well-being around the time of menopause. This is not surprising, since the winding down of fertility and the physical changes of midlife may lead women to contemplate their mortality and question the purpose and direction of their lives, as well as whether they had enough children. Those who wanted a child but were unable to have one may find menopause an especially sad or troubling period.

In studies, mood changes have been observed in up to 23% of peri- and postmenopausal women. Additionally, symptoms of anxiety—tension, nervousness, panic, and worry—are reported more frequently during perimenopause than before it, regardless of whether symptoms of depression are present or not.

Depression can be both a cause and a result of a sexual problem.

Depression, mood, and sex. The relationship between sexuality and depression or mood state is often complicated. Depression can be both a cause and a result of a sexual problem. For instance, a woman’s loss of desire may contribute to her depression, yet she also may see her desire decline as an effect of depression. Additionally, mood affects emotion, which affects relationship issues, which in turn have implications for sex.

Although low desire is the most frequent sexual side effect of depression or anxiety, other aspects of sexuality can also be affected. In women, orgasm may be more difficult to achieve when depression is present.

As many as half of patients who take SSRIs report some sexual dysfunction.

Sexual side effects of antidepressant drugs. Women with moderate to severe depression or anxiety will often be prescribed the popular antidepressant drugs known as SSRIs (selective serotonin reuptake inhibitors). Although the SSRIs are often effective in improving depression or anxiety, for many women (and men) they carry sexual side effects that include diminished sexual desire, trouble achieving and maintaining arousal, and difficulty achieving orgasm. As many as half of patients who take SSRIs—which include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and Celexa (citalopram), among others —report some sexual dysfunction.

The good news is that there are alternatives for patients with depression or anxiety whose sex life has taken a hit from SSRI therapy. Several non-SSRI antidepressants, including bupropion (Wellbutrin) and duloxetine (Cymbalta), are less likely to cause sexual dysfunction, and bupropion has even been reported to increase sexual drive and arousal in some women. Additionally, older antidepressant drug classes known as tricyclic antidepressants and monoamine oxidase (MAO) inhibitors are not associated with sexual problems, but they carry other potentially risky side effects. New antidepressants, such as vilazodone (Viibryd), continue to be introduced and need to be monitored for their effect on sexual function.

Another option is to reduce the dose of your SSRI in the hope of eliminating the sexual side effects without losing the treatment benefits for depression or anxiety. This is a delicate balancing act, however, and any changes in antidepressant therapy or dosing should be done only in consultation with your healthcare provider.

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Menopause

Menopause

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[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf

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Key Facts

• Menopause is one of the stages in a woman’s life cycle that marks the end of reproductive age. After menopause, a woman cannot become pregnant except in rare cases when special fertility treatments are used.
• Most women experience menopause between the ages of 45 and 55 as a natural part of biological aging.
• Menopause occurs as a result of the decline in ovarian follicular function and a decrease in circulating estrogen levels.
• The menopausal transition can be gradual. It usually starts with changes in the menstrual cycle. “Perimenopause” means the period that begins with the onset of the first signs and ends one year after the last menstrual period.
• Perimenopause can last for several years, affecting physical, emotional, mental and social well-being.
• Symptoms of perimenopause can be alleviated with various non-hormonal and hormonal agents .
• Menopause may result from surgical or medical procedures.
  

How does menopause proceed?

For most women, menopause is associated with the cessation of monthly periods (also known as “periods”) due to the decline of ovarian follicular function. This means that the ovaries stop releasing eggs for fertilization.

The regularity and length of the menstrual cycle varies during a woman’s reproductive life, but the age of natural menopause for women worldwide is typically between 45 and 55 years of age.

Natural menopause is considered to occur after the absence of menses for 12 consecutive months without any other obvious physiological or pathological causes and in the absence of clinical intervention.

Some women experience menopause earlier (before age 40). This “premature menopause” may be due to certain chromosomal abnormalities, autoimmune disorders, or other unknown causes.

It is impossible to predict when a woman will go through menopause, although there are links between the age of menopause and several demographic, medical and genetic factors.

Menopause may also occur as a result of surgery to remove both ovaries or medical interventions that suppress ovarian function (eg, radiation therapy or chemotherapy).

Many women stop menstruating before menopause, such as those who have undergone certain surgeries (hysterectomy or surgical removal of the lining of the uterus) and those who take certain hormonal
contraceptives and other medicines that lead to infrequent or no periods. However, they may experience other changes associated with the menopausal transition.

Changes associated with menopause

Hormonal changes associated with menopause can affect physical, emotional, mental and social well-being. The symptoms experienced during and after the menopausal transition vary significantly from woman to woman. Some have symptoms
practically absent. Others may experience severe symptoms that can affect daily activities and quality of life. Some may experience symptoms for several years.

Symptoms associated with menopause include the following:

• hot flashes and night sweats. Hot flashes are sudden sensations of heat in the face, neck, and chest, often accompanied by reddening of the skin, sweating (sweating), rapid heart rate, and intense physical discomfort.
  which may last several minutes;
• changes in the regularity and course of the menstrual cycle, ending in the cessation of menstruation;
• vaginal dryness, pain during intercourse and urinary incontinence;
• difficulty sleeping/insomnia; and
• mood changes, depression and/or anxiety.

These changes may also affect the composition of body tissues and increase the risk of cardiovascular disease. The advantage of women over men in terms of the risk of developing cardiovascular diseases is gradually decreasing.
not with a significant drop in estrogen levels after menopause. Menopause can also lead to weakening of the pelvic floor structures, which increases the risk of pelvic organ prolapse. Loss of bone density during menopause is significant
a factor contributing to an increase in the incidence of osteoporosis and fractures.

There are a number of non-hormonal and hormonal agents that can help relieve menopausal symptoms. Symptoms that affect health and well-being should be discussed with a healthcare professional to determine available options
their relief, taking into account medical history, values ​​and preferences.

Pregnancy is still possible during perimenopause. To avoid unwanted pregnancy, it is recommended to use contraceptives for 12 consecutive months after the last menstrual period. Pregnancy after menopause without fertility treatment,
involving the use of donor eggs or previously frozen embryos is unlikely.

During perimenopause and after menopause, sexually transmitted infections (STIs), including HIV, can still be contracted through unprotected sex, including oral, anal, and vaginal sex. Thinning of the walls of the vagina after
menopause increases the chance of damage and ruptures, which increases the risk of HIV transmission through vaginal sex.

The importance of understanding menopause

It is very important to consider menopause as one of the life cycle stages. The state of health of a woman entering the perimenopausal period is largely determined by the previous state of health, reproductive history, lifestyle and factors
environment. Perimenopausal and postmenopausal symptoms can be devastating to personal and professional life, and the changes brought about by menopause impact a woman’s health as she ages. Therefore rendering
Perimenopausal health care plays an important role in promoting healthy aging and improving quality of life.

Menopause can be an important transitional period, both socially and biologically. Socially, how a woman experiences menopause can be influenced by gender norms, family and sociocultural factors, including how aging
women and the menopausal transition are accepted in her culture.

The global population of postmenopausal women is growing. In 2021, women aged 50 and over made up 26% of all women and girls in the world. This figure has increased from 22% 10 years earlier[i]. In addition, the life expectancy of women is longer
than in men. In 2019d. women aged 60 worldwide could expect to live an average of 21 more years[ii].

Menopause can be an important opportunity to reassess your health, lifestyle, and goals.

Menopause-related public health issues

Perimenopausal women need access to quality health care and to communities and systems that can support them. Unfortunately, awareness of and access to menopause services remains serious.
problem in most countries. Often, menopause-related issues are not discussed in families, communities, workplaces, and health care settings.

Women may not be aware that the symptoms they experience are associated with menopause and that there are counseling and treatment options available to help relieve discomfort. Women experiencing menopausal symptoms may feel uncomfortable
or shame that prevents them from drawing attention to their experiences and asking for support.

Health care providers may not be trained to recognize perimenopausal and postmenopausal symptoms and counsel patients about treatment options and health care after the menopausal transition. Currently in programs
The training of many medical professionals has given limited attention to the problem of menopause.

In many countries, the sexual well-being of menopausal women is neglected. This means that common gynecological effects of menopause, including vaginal dryness and pain during intercourse, may remain.
without attention. Similarly, older women may not consider themselves at risk of contracting sexually transmitted infections, including HIV[iii], and may not receive safe sex or testing advice from their doctors.

Many governments do not have the health policy and funding to include diagnostic, counseling and treatment services for menopause as part of routine services. Menopause services are
presents a particular challenge in the presence of other urgent and competing health financing priorities.

WHO activities

WHO believes that social, psychological and physical health support during the menopausal transition and after menopause should be an integral part of health care. WHO aims to improve understanding of menopause through
following events:

• raising awareness of menopause and its impact on women at the individual and community levels, as well as on the health and socioeconomic development of countries;
• advocacy for the inclusion of diagnostic, treatment and counseling services for menopausal symptoms in the universal health coverage package;
• Promoting the inclusion of menopause education and treatment options in pre-service training programs for health workers; and
• promoting a lifelong approach to health and well-being (including sexual health and well-being) by ensuring that women have access to relevant health information and services to promote healthy
  aging and a high quality of life before, during and after menopause.

Notes:

and self-identify as women), transgender men and some individuals who do not identify as either male or female are also going through menopause.

In this fact sheet, “women” are referred to according to available data, which usually does not specify gender identity. There is little data available on the experience of menopause among transsexuals and individuals with
gender identity. Transgender people and individuals with different gender identities have their own age-related health needs that clinicians should consider, including referral to specialized
services.

2) Although menopause is not a disease, in this fact sheet what women experience during perimenopause and postmenopause is
called symptoms because it can cause discomfort that affects quality of life.

---

[i] United Nations, Department of Economic and Social Affairs. (2021) World Prospects 2021. https://population.un.org/wpp/Download/Standard/Population/

[ii] United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Aging 2019: Highlights (ST/ESA/SER.A/430). https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf

[iii] UNAIDS. The Gap Report 2014: People aged 50 years and older. Geneva, Switzerland. (2014). UNAIDS. https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf

Women’s Health

Sexual and Reproductive Health and Research (English)

Aging

Sexual health

Personal care: Self-care: Lenta.ru

Scientists have calculated that every third woman is afraid of menopause. Many perceive age-related changes in the body as harbingers of old age and changes for the worse. The President of the Russian Menopause Association, an obstetrician-gynecologist of the highest qualification category, Professor Vera Balan believes that this natural process should not be feared. In a conversation with Lenta.ru, she told how to enter a new period of life healthy, vigorous and happy.

Lenta.ru: Many women break out in cold sweat at the word “menopause”. It seems to them that with its onset, life almost ends. What is menopause from a medical point of view and should we be afraid of it?

Vera Balan: All life is divided into regular stages: birth, the onset of puberty at the age of 8-14, and then puberty. At this moment, the girl passes from childhood to puberty – she is ready for reproductive life. The purpose of the reproductive period in a woman is pregnancy and childbirth.

After the age of 35, women’s fertility declines, egg production drops sharply. This is provided by nature so that a person cannot become pregnant and give birth an infinite number of times.

Menopause is just one of the stages of a woman’s life cycle, which marks the end of the reproductive age. We can talk about it a year after the last menstruation.

There is no need to be afraid of this physiological period, you just need to live it correctly

Vera BalanPresident of the Russian Menopause Association

Most women think that menopause is directly related to the loss of femininity: the reproductive function has ended, and maybe life has ended with it? Actually it is not. At this time, we cease to be dependent on the hormonal background, and for some, this age is the most successful in professional terms. Consider, for example, Indira Gandhi, who at the age of 48 became India’s first female prime minister.

To make this transition as comfortable as possible, you need to follow a few rules, but not only when the last menstruation is approaching, the whole life should be devoted to this.

Photo: Shutterstock

What are these rules?

If a woman wants to remain socially active, be visible and keep up with her younger colleagues, then for this you need to make an effort, monitor your diet and do not forget about moderate physical activity. You can start with simple stretching exercises: bending over, swinging your legs, lifting your arms – they will maintain the elasticity of the muscles and balance the body.

A healthy lifestyle from a young age is already 50 percent of success. If we add to this the help of a specialist, a favorable environment, then a woman will easily endure the transition to menopause, and her life will be long and fruitful.

Do women always have a hard time enduring this transitional period? What health problems can arise?

Someone endures this period easier, someone harder. A woman who is very active during the reproductive period, who has had many births and abortions, is more difficult to enter into this hormonal-estrogen deficiency. She has severe vegetative symptoms, which hide high risks of developing cardiovascular diseases.

Today, more and more women die from strokes, heart attacks and thromboembolism, and not from oncology, which everyone fears. In addition to such obvious autonomic disorders, various urogenital disorders develop in parallel: dryness in the vagina and pain during intercourse appear, libido decreases.

During this period, a woman’s metabolism is rebuilt, she gains weight, her figure changes: the waist becomes larger, the tummy appears

Vera BalanPresident of the Russian Menopause Association

When fat is deposited around the waist and shoulder girdle, this may indicate visceral obesity, which is often a precursor to insulin resistance and diabetes mellitus. In this case, a woman should be especially careful about the choice of food, lifestyle and hormone therapy.

During the transition to menopause, a woman gains an average of one kilogram of weight per year. Then, after two or three years, weight gain stops, but it is very difficult to bring the waist back to its former parameters.

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What are the signs that menopause is approaching?

First of all, menstrual irregularities can become a signal. It may become shorter or longer, there may be delays, and then for some time the cycle may be restored again. Then, seemingly insignificant symptoms appear: excessive sweating, sleep fragmentation (a woman may wake up frequently at night), hair loss, or even slight memory problems.

Ask any woman over 45: “Do you forget words?” Most likely, she will answer: “Yes, sometimes I forget.” Also characteristic signs are changes in the figure and weight gain. Moreover, the condition of the skin may worsen: it becomes oily, enlarged pores appear. These are the symptoms to watch out for.

52

years

the most probable age of menstruation

It happens that menstruation in women stops at the age of 47-50 years, and then resumes again. Why is this happening?

It is important to understand how long they stopped. If, for example, for six months, and then resumed, this is normal. So the woman enters menopause. And if suddenly there was no menstruation for a year or two, and then it appeared, you need to look for a concomitant pathology.

Does menopause get younger? Periodically, you can see information that menopause occurs even in 40-year-old women.

No, it’s not. If we take the population, it is not getting younger, but, on the contrary, it is getting older. The age of menopause is now moving up. Early menopause occurs in some cases, when there is a genetic predisposition to this or other problems.

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What are the chances of a woman getting pregnant if she is approaching menopause?

Even a year after the last menstruation, there is a chance of pregnancy. Therefore, the problems of women in this transitional period are very different: someone wants to have a child and is trying to get pregnant, someone else needs contraception, and someone needs hormone replacement therapy.

Does a woman’s psyche change with the onset of menopause?

Here it is important to note that it is not the psyche that changes, but disorders appear that are associated with hormonal changes – psycho-emotional disorders.

If a specialist prescribes the right treatment, these disorders can be leveled

Vera BalanPresident of the Russian Menopause Association

Separately, it is worth mentioning that during the transition a woman may develop depression, it is important to pay attention to this, immediately contact a specialist and add special therapy. But over time, all these changes smooth out.

What happens in intimate life?

During menopause, a woman may experience decreased libido, vaginal dryness and discomfort during intercourse. 30 percent of sexual disorders occur due to atrophy of the mucous membranes of the urogenital system. We can fix this.

However, do not forget that the partner changes, even faster than a woman. And here it is already important to take into account other components, including the relationship between a man and a woman.

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How should relatives, and especially partners, behave if a woman is having a hard time with menopause?

The best advice from relatives would be to contact a good gynecologist. It is also important to show participation and involvement: to be interested in well-being, to remind them to follow the prescribed therapy. If a specialist has recommended a diet, you can for the first time refuse some products with your partner. The main thing is to create a comfortable and trusting atmosphere, to provide maximum support.

There is a lot of advice on the Internet about how to behave during menopause. What is worth believing?

First of all, you need to trust your doctor, who knows the problem well. As a rule, this is a gynecologist and an endocrinologist. But for a woman to see a doctor, resources and projects are needed to help make the problem “visible”.

If we are talking about Internet resources, then you should pay attention to platforms developed by specialists. For example, the Menopause Guide tells women in an accessible way about the symptoms of menopause (menopause), self-help techniques to alleviate the condition, and also answers questions that women are embarrassed to ask at a doctor’s appointment.

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What will the doctor prescribe?

If there are no contraindications, a specialist may prescribe menopausal hormone therapy. A competent doctor can choose a combination of drugs: herbal and drugs that affect the central nervous system, for example, modern antidepressants.

In the case of menopause, we prescribe menopausal hormone therapy (MHT). It reduces all-cause mortality by 30 percent and reduces cardiovascular mortality by half.