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The primary symptoms of menopause are vasomotor and genitourinary. Vasomotor symptoms ("hot flashes") cause daytime discomfort and chronic insomnia. A thin, dry vaginal lining and thin urethral mucosa can cause vaginal and vulvar irritation, pain during intercourse, and an increased risk for urinary tract infection.
HORMONAL THERAPIES — Estrogen – Oral, intramuscular, topical, transdermal, and vaginal ring formulations of estrogen are approved by the FDA for treatment of vasomotor symptoms. Some are also approved for vulvar and vaginal atrophy associated with menopause. Systemic estrogen is the most effective treatment for menopausal vasomotor symptoms. It decreases hot flashes by 50-100% within 4 weeks of starting treatment.1 The lowest effective dose and duration of estrogen therapy remains unknown, and the search for effective alternatives continues. For patients with... more
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