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News from the journals 2005: What are the alternatives to HRT?


In light of increased publicity of risks of HRT, many women have turned to
the use of alternative therapies. An excellent review of alternatives to
hormone replacement therapy for management of menopausal symptoms in Current
Obstetrics and Gynaecology, August 2005, highlights the fact that there is
much confusion about the choice of treatments available and that very little
is known about their exact constituents, safety and their possible side effects
and interactions with other therapies. A further review article on a similar
theme: Treatment of menopausal symptoms: what shall we do now? published
in The Lancet, explained that many doctors and women have changed their view
on HRT use over the last few years. Many women have stopped HRT and suffered
from recurrence of menopausal symptoms and many have tried alternative therapies.
The article emphasises that oestrogen alone or oestrogen combined with progestogen
are probably the most effective treatments currently available for menopausal
hot flushes and vaginal dryness. The synthetic form of HRT, Tibolone is as
effective as conventional HRT and may also improve libido. Little information
either on safety or effectiveness is available for complementary therapies.
Some other prescribed medications may be effective, such as selective serotonin
reuptake inhibitors. A further article, again published in the Lancet, demonstrated
that Gabapentin, a drug used to treat nerve pain and epilepsy, can reduce
hot flushes by about 46% and can be considered for those who cannot, or who
do not wish to take HRT for menopausal symptoms.

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