The Latest on Treatments for Post-Menopausal Women

Millions of women seek help to relieve the unpleasant symptoms often associated with menopause. Hot flashes, night sweats, sleep disturbances, mood swings, and the mental fogginess that comes with sleep deprivation are among the common symptoms that drive women to seek help. But in two new studies focused on mental wellbeing and functioning, researchers found little benefit in various treatments. We spoke with a gynecologist to help clear things up.

Hormone Therapy and Brain Function

According to a study done by researchers at the University of Wisconsin and published in the June, 2015 issue of PLOS Medicine, menopausal hormone therapy (a.k.a. hormone replacement therapy) did not improve cognition—the activities of thinking, understanding, learning, and remembering. The study was based on observations of 693 recently postmenopausal American women who were randomly assigned to receive either hormone replacement pills, transdermal patches (sticky medicated patches applied to the skin), or placebo versions of the same. Over the four years these women were studied, researchers found no beneficial effects of treatment on cognition or depression. However, women who received hormonal therapy via a patch did report some improvement in mood symptoms.

Does this mean hormone therapy isn’t a viable option? Janet Gibbens, MD, an obstetrician/gynecologist at The Oregon Clinic, in Portland, is skeptical of the research: "The problem with this study is that it only followed a relatively small group of women for a short period of time during years when cognition is rarely a serious problem," she points out. "Recently postmenopausal women are usually in their late 40’s and early 50s. We don’t generally see cognitive problems in that age group. These issues may start showing up 10 to 20 years later, if they develop at all."

She continues, "Women often feel less foggy-headed from sleep loss and their mood swings may stabilize with hormone replacement therapy, however. As for clinical depression, hormone therapy is never considered the treatment of choice. I wouldn’t anticipate it to be helpful in that area."

Supplements and Symptoms

The other study, published in June in Maturitas, the journal of the European Menopause and Andropause Society, focused on the effects of vitamin D and calcium supplements on menopausal symptoms. Researchers looked at data taken from the Women’s Health Initiative, one of the largest clinical trials to study common causes of death, disability, and quality of life in menopausal women. The investigators concluded that when it came to relieving common symptoms of menopause, these supplements were not effective.

Again, Gibbens was not very concerned by the results: "The symptoms that women seek relief from most include hot flashes, night sweats, and, sometimes, sleep disturbances that can contribute to mood swings. I’m not sure why researchers thought vitamin D and calcium supplements would be useful for those, though they can certainly help protect the bones of menopausal women as they age."

Relief for Menopause Symptoms

So what does help relieve common menopause symptoms? Gibbens says that hormone replacement therapy that delivers estrogen and progesterone either via pill or a patch is very effective for most women. Other remedies, including acupuncture, Chinese medicine, exercise, and the use of herbal supplements are reported to be helpful for some women.

But the best course of action for women seeking help as they transition through menopause is to talk to their healthcare provider about the therapies that are most appropriate for them.

Janet Gibbens, MD, reviewed this article.

Sources

Janet Gibbens, MD. Interviewed June 22, 2015.

Gleason C.E., N.M. Dowling, W. Wharton, J.E. Manson, V.M. Miller, C.S. Atwood, et al. "Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS–Cognitive and Affective Study." PLoS Med (2015) 12, 6: e1001833. doi:10.1371/journal.pmed.1001833.

"Vitamin D and Calcium Supplements Do not Improve Menopausal Symptoms." Medical News Today. June 2, 2015.

LeBlanc E.S., H. Hedlin, F. Qin, M. Desai, J. Wactawski-Wende, N. Perrin, J.E. Manson, K.C. Johnson, K. Masaki, F.A. Tylavsky, M.L. Stefanick. "Calcium and Vitamin D Supplementation Do Not Influence Menopause-Related Symptoms: Results of the Women's Health Initiative Trial." Maturitas (2015) J81, 3:377-83. doi: 10.1016/j.maturitas.2015.04.007. Epub 2015 Jun 1.