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torrancememorial.org PULSE | 19 the uterus from cancer," Dr. Sanders continues. "Further, if a woman has a history of liver disease, a transdermal patch to deliver estrogen is a better route versus an oral formulation which is processed through the liver." Dr. Rodriguez says HRT is a viable option depending on the severity of symptoms. "Some women have milder symptoms and choose to wait before initiating treatment while others have severe symptoms that reduce their quality of life. If still in perimenopause and a non-smoker, patients can be offered a low dose birth control pill that contains both estrogen and progesterone. Once a patient meets criteria for menopause we then change the dose based on risk factors, type and severity of symptoms. If a patient has a history of heart disease, stroke, liver disease or breast cancer that is estrogen receptor positive, they are not good candidates for hormone replacement therapy. Ultimately, we need to weigh the risks with the benefits. We know hormone replacement therapy resolves the hot flashes, mood swings, vaginal dryness and may help stop the progression of bone loss in patients with osteoporosis. It may even help increase HDL (high density lipoprotein), which we know can be cardio protective." ARE THERE ANY SUPPLEMENTS OR NONHORMONAL PRESCRIPTIONS THAT CAN HELP? "ere are different treatments that are either over-the-counter (OTC) or nonhormonal prescriptions that can help reduce symptoms," Dr. Sanders says. "One nonhormonal prescription treatment is a low-dose antidepressant, known as paroxetine and goes by the brand name Brisdelle. It acts on the nervous system to help reduce night sweats. An OTC treatment called Relizen (from a Swedish flower) helps minimize hot flashes but takes a few months to work. Another OTC called Estroven (with soy and wild yam extract) calms hot flashes and night sweats." "I like to consider the whole picture when looking at a patient," Dr. Huete says. "SSRI (anti-depression) medication can be helpful. I encourage patients to talk to their doctors if they're experiencing unpleasant symptoms related to perimenopause and menopause. Some doctors may be uncomfortable prescribing hormones, so it's important to find a doctor who will work with you. Many women are living well into their 80s, and HRT can help women feel energetic and attractive and maintain a good quality of life." In addition to OTC products, "bioidentical" topical hormones and synthetic oral hormones, there is a laser treatment called Mona Lisa that can help with painful intercourse, vaginal dryness and atrophy. "is is a good option for women who have a contraindication to hormone replacement therapy or are uncomfortable taking medications and experiencing only vaginal symptoms," says Dr. Rodriguez. "e laser helps rejuvenate the vaginal wall and promote collagen and elastin formation. Other ways to help alleviate symptoms of aging and menopause are to get regular weight-bearing exercise. I encourage my patients to stay active, take classes to help stimulate their minds and not to go down without a fight. Menopause can be the best years of your life." • A S K T H E D O C