Symptom Finder - Treatment of Menopause
MENOPAUSE
A. Patients with a hysterectomy and no history of breast cancer in themselves or their family:
1. Conjugated estrogens (Premarin): 0.625–1.25 mg daily, 25 days a month.
2. Alternatively, may give estradiol cypionate (Depo- Estradiol): 5 mg IM monthly.
3. Some patients do better with esterified estrogen + methyltestosterone (Estratest): 1 tablet daily 25 days a month.
B. Patients with a history of breast cancer in themselves or their family:
1. Avoid hormone replacement therapy.
2. Clonidine (Catapres): 0.05–0.1 mg bid to control hot flashes.
3. Fluoxetine (Prozac): 20 mg daily.
4. Gabapentin (Neurontin): 300–600 mg tid to control hot
flashes.
5. Over-the-counter natural estrogens (Estroven, etc.) may be
tried.
6. Osteoporosis prophylaxis.
A. Patients with a hysterectomy and no history of breast cancer in themselves or their family:
1. Conjugated estrogens (Premarin): 0.625–1.25 mg daily, 25 days a month.
2. Alternatively, may give estradiol cypionate (Depo- Estradiol): 5 mg IM monthly.
3. Some patients do better with esterified estrogen + methyltestosterone (Estratest): 1 tablet daily 25 days a month.
B. Patients with a history of breast cancer in themselves or their family:
1. Avoid hormone replacement therapy.
2. Clonidine (Catapres): 0.05–0.1 mg bid to control hot flashes.
3. Fluoxetine (Prozac): 20 mg daily.
4. Gabapentin (Neurontin): 300–600 mg tid to control hot
flashes.
5. Over-the-counter natural estrogens (Estroven, etc.) may be
tried.
6. Osteoporosis prophylaxis.
