Menopause

WOMEN seeking treatment for hot flashes have few options besides hormone therapy, and more research is needed to understand what really helps, according to a new study. Published last week in the Journal of the American Medical Assn., it found that antidepressants such as fluoxetine (Prozac) and paroxetine (Paxil) appear to curb frequency and severity of hot flashes, and that gabapentin (Neurontin), an antiseizure drug, and clonidine, a drug for high blood pressure, can help too.

Post-menopausal estrogen therapy does not appear to protect women in their 60s and older from heart disease, but researchers say it may have some protective effect for women in their 50s. The Women's Health Initiative, which conducted the research, stopped the analysis in March 2004 because of a higher risk of stroke among women taking estrogen. But further examination of the data shows that, at least for women between 50 and 59, the hormone may provide a boost to heart health.

Post- menopausal women have another option to treat early-stage breast cancer with the approval Wednesday of a drug aimed at stopping recurrences. The U.S. Food and Drug Administration approved Femara, a medication manufactured by Novartis Pharmaceuticals and belonging to the class called aromatase inhibitors. Femara already is approved for post-menopausal women with advanced breast cancer.

MANY women bade farewell to hormone therapy after a major study found risks from taking hormones after menopause -- and far fewer benefits than once believed. But not all. Some women felt that, for them, the benefits outweighed the risks. Others turned to "bioidentical hormones," which are synthesized from soy and yams and are similar to the hormones the body produces. They're much more similar, for instance, than the hormones in pills such as Prempro and Premarin.

A study of gorillas at 17 North American zoos, led by researchers at Chicago's Brookfield Zoo, is the first to document gorilla menopause. The average age of the postmenopausal gorillas was 44. In American women, meno-pause hits around age 51. Many biologists believe menopause evolved because it gave human grandmothers more time to help care for their grandchildren.

The bad news came on July 9, 2002: Scientists had abruptly halted a major study of hormone-replacement drugs for menopausal women after finding links to breast cancer and blood clots. Santa Monica gynecologist Karen Blanchard remembers that summer as "horrible. We received at least 20 calls a day from hysterically upset patients, and many, many women stopped taking hormones." Next, following a now-familiar pattern, came the lawyers.

AS her body adapts to the changes of menopause, 52-year-old Nancy Bouche has good days and bad. But one thing is for sure -- since starting Pilates three years ago, she has more energy, less stress and a striking drop in hot flashes. "I used to have them every day," she says, "and now I can go for weeks without having any." Bouche, an executive assistant at Nickelodeon Animation, is a testament to the power of exercise over menopausal symptoms.

Nearly two-thirds of women who use hormone supplements to stop menopausal symptoms such as hot flashes, night sweats and depression suffer a recurrence or a worsening of symptoms after they stop the therapy, according to a study published today. But many of the 63% who had a recurrence were able to alleviate the symptoms with "lifestyle changes, such as drinking more fluids, starting or increasing exercise [and] practicing yoga," said one of the authors, Dr.

Re "A Question for the Ages: To De-Bag or Not," Commentary, July 5: As I sat in the middle of the post-Fourth of July block party debris, sipping my morning coffee and musing over the previous day's family conversations, I chuckled out loud at the reflections of Dinah Lenney and her puffy eyes. Unlike her mother, I work hard at pumping up the self-esteem of my six now-adult hatchlings and their spouses, and they still think I'm wrong or unhelpful most of the time. Lenney's theory about 11-year-old girls being as fully realized as they will ever be again until after menopause is wonderful.

Worried that women in the United States may be turning too quickly to treatments for symptoms of menopause, a panel of medical experts suggested that those without severe problems simply wait out the changes their bodies were undergoing. Evidence links sleep disturbances to menopause, which is associated with hot flashes, night sweats and vaginal dryness, a National Institutes of Health panel said Wednesday.