More New Menopause Drugs Offer Hope

Toni Hurst Health Guide
  • One of my last blog posts was about new drugs being developed to help relieve menopausal symptoms. Since then I've found even more drugs or treatments that are new or in the works. I am so excited about them, I wanted to share right away!

    Some of these drugs are being researched by huge pharmaceutical companies, and while I'm no cheerleader for the big drug companies, just the fact that they are looking into this stuff indicates to me that they think there are some useful treatments out there.

    Note that most of these are just in development: only one is on the market yet, and another is available by prescription but not for the treatment of menopause symptoms. But you may see some news about these fairly soon.

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    The biggest complaint from most of us is our hot flashes, so no surprise that researchers are trying to find a "cure."  Fact is, there isn't really a cure, since menopause is a natural phase of life. Our body's decreasing levels of estrogen is a main factor in triggering those vile hot flashes.

    But taking estrogen to combat the symptoms of menopause has had some serious side effects in many women, so scientists are trying to come up with the "good" while eliminating the "bad."

    One of the newest ways to deliver estrogen that some scientists say is safer than the pill form is via a gel that can be applied to your upper arm or shoulder. New to the market is a low-dose, prescription-only gel used to treat moderate-to-severe hot flashes called Elestrin.

    Elestrin is transdermal (through-the-skin) estradiol (a plant-based estrogen). In studies, it has been proven to significantly reduce the number and severity of hot flashes. It comes in a pump like some facial moisturizers and one pump delivers the smallest amount of the hormone, and of course two pumps delivers more. Patients should not use any more estrogen than is absolutely necessary to relieve symptoms. The drug, which is on the market already, carries a pretty severe warning and should not be used by women who:

    • Have unusual vaginal bleeding
    • Currently have or have had certain cancers, including cancer of the breast or uterus
    • Had a stroke or heart attack in the last year
    • Currently have or have had blood clots
    • Currently have or have had liver problems
    • Are allergic to it (duh!)
    • Think they may be pregnant

    Your doctor or nurse practitioner may have heard of this-ask her about it.

    Another gel-form drug in development is LibiGel, which, if approved, may be used to treat low sexual desire in menopausal women. It's also a hormone, testosterone. Testosterone, of course, is a hormone we associate with men.

    Both men and women have testosterone, and its potency decreases as we age. Researchers say its deficiency decreases libido or sex drive. In addition to increasing sexual desire and activity, some scientists says that testosterone therapy can increase bone density, raise energy levels and improve mood. These are not crackpot scientists, either. The goal of testosterone treatment is to get our testosterone level back up to what it was before menopause. Because it is absorbed by the skin, the gel enters the bloodstream over time.

  • According to the company's material, studies are being conducted to show that "LibiGel can safely improve women's sexual desire and the frequency of satisfying sexual events and decrease personal distress associated with low sexual desire in women."

    Hip Hip Hooray!

    But not so fast: Messing with your natural hormone levels can play terrible tricks and I'm not talking about growing a mustache: things like heart attacks and strokes. So the company making Libigel is doing a cardiovascular safety study with 2,400 women who take it over 12 months, and will continue to follow the women for an additional four years after it submits the drug for approval. The incidence of breast cancer is also being tracked throughout the study.

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    Another group of scientists is taking an entirely different approach to "curing" hot flashes. In stead of using estrogen, they are researching selective estrogen receptor modulators (SERMs). I don't really understand all the science, but what I've been able to find out is that they do not pose the dangers that estrogen replacement therapy poses, and they somehow trick the brain. The drug being studied doesn't have as cool a name as the ones mentioned before; it's called RAD1901 for now. The first trial is on 100 women and there will be lots of followup trials with more subjects, but it's a start. SERMs are not new; they are used to treat breast cancer and osteoporosis, but according to the research, they usually make hot flashes worse, not better. Something about this one is different.

    One other drug shows promise and you may have heard of it: escitalopram, better known as Lexapro. It's used to treat depression and anxiety disorders. Heaven knows some of us suffer from that during menopause and may be using it already. The researchers say it is a selective serotonin reuptake inhibitor (SSRI) and that those increase serotonin, a brain substance that influences mood. Serotonin may also affect brain levels of estradiol, a hormone related to hot flashes.

    This research is studying whether escitalopram reduces menopausal hot flashes in addition to elevating our moods.  Scientists say estrogen may keep us from getting depressed and so when levels decline at menopause, our mood declines as well. I didn't know this but apparently estrogen is sometimes prescribed for depression. But estrogen has serious side effects. So if Lexapro treats anxiety and depression, ALSO diminishes hot flashes, and isn't estrogen, well, won't that be a wonder drug?

    And finally, other good news: Investigators have demonstrated promising results with omega-3 fatty acids as a treatment for depression associated with menopause.

    Omega-3 fatty acids are found in foods (such as fish) and have widely established health benefits. Omega-3 fatty acids are polyunsaturated fatty acids; it is incredibly easy to increase your intake of them. I don't know whether you can get enough through food to counter depression, but there have been studies on how they can treat bipolar depression. Scientists found increased omega-3 fatty acids in blood plasma in women who were undergoing hormone replacement therapy (HRT)or who were on birth-control pills, which are a dose of hormones. The omega-3 fatty acids may account for HRTs antidepressant effects, they say. If menopause causes a decline in estrogen levels, therefore, lower amounts of omega-3 fatty acids may be available to the brain. The research is to determine if supplementing omega-3 fatty acids after menopause increases the level enough to eliminate or reduce the depression.

  • That's a lot of info I know, and some of it is hard to understand. But rest assured I'll keep on top if this and see whether these new drugs are what they're cracked up to be (and if they aren't).

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Published On: June 16, 2009