Menopause: Vasomotor Symptoms, Systemic Treatments and Self-Care Measures

摘要

Since women's life expectancy is increasing all over the world, most of them are expected to live a significant part of their life in menopausal status. This period marks the end of the reproductive status and, in addition to bringing about negative feelings about this, might be accompanied by many complaints due to the decline of circulating estrogen levels. The most common complaint during this period is related to vasomotor symptoms such as hot flashes and night sweats. Although not all women are bothered by them, vasomotor symptoms represent a very frequent and distressing occurrence. The mechanism by which vasomotor symptoms are triggered has not been fully clarified yet, but the link of these symptoms with low estrogen concentrations has been well established. Low estrogen levels result in disturbance of the temperature regulating mechanism situated in the anterior-preoptic hypothalamus, where there is a thermoneutral zone that is reduced after menopause, becoming hypersensitive to hot stimuli and abnormally inducing hot flashes.. Also, estrogen is known to influence serotonin, endorphin, noradrenalin and dopamine levels, and neurotransmitters that have been associated with regulatory mechanisms in body temperature control. Additionally, hypoestrogenism may interfere with vascular reactivity to the inputs from this altered thermoneutral zone. This culminates with symptoms including sudden feelings of warmth and skin redness that begin in the chest and spread to the neck and face, accompanied by sweating, palpitations, anxiety and sleeping disturbance that potentially impair the quality of life of women. The management of these symptoms includes hormonal replacement therapy (HRT) that constitutes the basis of the treatment of menopause symptoms especially regarding hot flashes. Some measures including lifestyle changes are useful to reduce vasomotor symptoms and should be considered in all cases. The efficacy of complementary alternative medicine therapies r...