SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMs)
These comprise a new class of medication. They mimic estrogen activity in selected tissues. In other tissues, they may exhibit estrogen-blocking activity or little or no effect. Consult your physician for their uses.
Gynecological Issues:
The drop in estrogen production results in a thinning of the vagina and a loss of elasticity of the mucous membranes of the vulva, vagina and other tissues (eg the breasts). The decrease in levels of estrogen can lead to vaginal dryness, itching, and sometimes discomfort and pain during sexual intercourse. Vaginal moisturizers can relieve this.
The bladder and the urethra (the channel through which you urinate) also responds to estrogen, and when this is deficient, symptoms such as slowing of the urinary stream, difficulty in urinating and increase in urination both during the day and especially at night, occur. There may also be recurrent episodes of bladder infections and urinary incontinence (loss of urine and poor control when coughing or running).
With the onset of menopause, a drop in estrogen and testosterone occurs. A woman often feels a decrease or loss of sexual drive. This can be improved by supplementing these low hormone levels with estrogen and occasionally testosterone.
There is an acceleration in the aging of the skin due to environmental factors such as sunlight, chemical exposure and stress. A drop in estrogen after menopause speeds up this process, resulting in a decrease of elasticity and turgor. The skin becomes more dry; wrinkles and fine lines appear to be more significant. Hair can become finer and more dry as well.
These symptoms can be improved with good skin care, and chemical skin peels.
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Vaginal moisturizers replenish the lost moisture and restore the elasticity within the vagina, which may be caused by the decreased level of estrogen. With prolonged use they can also help normalize vaginal pH. Products such as Replens are effective due to the length of time that they remain in the vagina. This is possible due to their bioadhesive (biological - adhesive) properties, which help such products adhere to cells lining the vaginal walls, and thereby allow for the absorption of water into these cells.
We know that a common complaint of perimenopausal women is change in their mood and mental well-being. This can continue and even progress in some women. A decrease in estrogen may lead to a blunting of cognitive function and memory loss.
More severe mood swings can at times progress to clinical depression. This can result in a woman feeling so depressed that she cannot function, lacks energy and interest in day to day activities, and may become suicidal. This becomes a medical condition that requires immediate attention.
Some studies have suggested that in certain women with a family history of Alzheimer's disease, the onset of menopause can result in the development of this disorder.
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