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Re: menopause symptoms-Dr. MarchbeinFrom: Christine (anonymous@obgyn.net)Tue, 19 Oct 1999 08:48:34 -0500 (CDT)
At Mon, 18 Oct 1999, Harvey S. Marchbein, M.D. wrote: > >At Mon, 18 Oct 1999, Christine wrote: >> >>I am curious about menopausal symptoms, specifically hot flashes. On >>average, how long do these last? > >Some women don't get them at all and some get them for several years, >occasionally on and off. > >>I am 49 years old, TAH (ovaries left >>in) in 1986. My FSH level in Jan 99 was "9". In July 99 I started >>having hot flashes (these felt like the real thing, as I was familiar >>with them from Lupron treatment several years ago) >>Coincidentally I had started taking celebrex for an arthritic condition >>and one of the less common side effects of the drug appears to be "hot >>flushes." I stopped the drug after about 6 weeks but the hot flashes >>continued until mid September and then stopped suddenly. (about a month >>after stopping the drug) Do you think these hot flashes were related to >>menopause and coincidentally occurred at the time I was taking this >>drug? > >Certainly possible. > >>Would it be normal for a woman to have hot flashes for only about >>a month before her body adjusted to the decrease in estrogen? > >Hot flushes are actually a response to a changein estrogen from low to >high and back again. It's the change, not an absolute low OR high >level. Studies have actually shown a higher level of estrogen than >prior to the hot flushes. > >>I know an >>adjustment must take place because women don't usually have them for the >>rest of their lives, although I've heard where hot flashes sometimes >>continue for as long as 5 years. > >Possible. > >>Or could this be perimenopause where >>there might have been a dip in estrogen production, enough to cause hot >>flashes? Does it work that way? > >Answered above. > >>Thank you >> >>Chris S. > >-- >Harvey S. Marchbein, M.D. FACOG, FACS >Great Neck, New York > Thank you for your explanation. This would mean to me then you should not expect a change in the FSH (to indicate menopause, I realize the FSH changes according to the menstrual cycle)until after the hot flashes end, since they (the hot flashes) are a response to the changing levels of estrogen and not necessarily low levels of estrogen. How long does the estrogen have to be at a menopausal level before the FSH reaches menopausal levels? I have read that FSH is not a reliable indicator of menopause.(until long after it has occurred I guess) So why then does it seem that doctors do not start estrogen replacement until blood tests indicate the FSH has reached menopausal levels? If a woman has irregular periods of hot flashes, and no uterus as an indicator of what's going on, wouldn't starting ERT be helpful? I have also read that bone loss occurs at a greater rate in the first years after menopause, so wouldn't it be better to be more cautious about possible low estrogen levels? Or does the fact that hot flashes are occuring indicate that there is enough estrogen there, although erratic? By the way, I was just at a lipids workshop and the cardiologist remarked that he thought that all menopausal women should be on estrogen, unless contraindicated, but not necessarily for cardiovascular protection, that there are better ways of doing that such as cholesterol control, lifestyle, etc. Chris S.
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