It’s a vicious cycle, so as women develop more and more vasomotor symptoms, we also see that carry through into other changes that affect concentration, one may be having anxiety attacks, memory changes, particularly short term memory changes that affects mood and irritability, and then loss of libido becomes an issue as well. This is kind of a complicated slide, but very important because it’s the basis for a lot of current research. What we know is that as the active estrogen drops, that affects the neurochemistry of the brain, and in particular, it affects tryptophan and serotonin which we know is the hormone associated with depression and well being. What we see, even slight changes occur in the perimenopause with estradiol. We already see change in the sense of well being, so just the addition of estrogen has been found to increase or enhance well being, and as a result, alleviate depression. There is a certain group of women, that in spite of replacing the estrogen, the serotonin levels do not come up to their baseline, and in that group of women, probably they would need an SSRI or a serotonin re-uptake inhibitor that would increase the serotonin levels and enhance their sense of well being. The other important change in the change in the ratio of norepinephrine to dopamine. So this accounts for more anxiety, more inability to cope with daily activity or stresses of daily life, and it also interferes with sleep patterns. So what we see is that women during this time have an interruption in their sleep and as a result, they go night after night of restless sleep, they wake up tired, their inability to concentrate and to remember becomes enhanced, and as a result that can lead to further depression of the serotonin levels and further alteration in the stressors that we see here.
Cheap generic propecia 5 mg at Online generic pharmacy
So there have been many studies looking at sleep patterns, at memory, at different quality of life issues in women during this time and it has clearly been found that the addition of estrogen as well as estrogen and progesterone clearly enhance rem sleep, giving longer REM cycles and more restful sleep, so that a woman feels better, so that in term adds to overall well being. There are also less complaints during this time if a woman is on estrogen because indeed she does feel better and she is not so concerned about sleep anymore, unless of course there is a urogenital problem.
Buy abilify
Then we talk about mood and fatigue, and once again, we see women who have been treated with an estrogen or estrogen progesterone combination who have reported less anxiety, less depression, and overall better sense of well being. What about the urogenital tract, we know as the levels of active estrogen begin to decrease, we see changes in the urogenital tract and this may occur as early as the 40s before a woman actually progresses into her menopausal years. The vulva, vagina, urethra, and bladder are all very estrogen sensitive organs, and with the lack of estrogen, there is a lack of collagen and a subsequent lack of lubrication. This give rise to changes in bladder function, it gives rise to changes in sexual function. So as a result, we see very commonly, complaints of frequency, urgency, very common complaints of nocturia, and often times complaints of incontinence. Some of the other symptoms we hear about are burning, itching, painful intercourse and this again is due to lack of the tone within the vagina as well as decrease in vaginal secretions. Sexual dysfunction symptoms that we see, once again, decrease in sexual desire or sexual response, this may be associated with changes in the hormones as well as what is going on in the urogenital tract. These symptoms are very pronounced in women after a surgical menopause. What we do know about estrogen and estrogen replacement in this area is that just the addition of an estrogen topical cream would promote strengthening of the muscles, will enhance the blood flow and lubrication to this area. It promotes the return of the pH, so that women have less bladder infections, they have less symptomatology during this time.
Sexual functioning, although the studies are very limited, and they are based on very short term treatment with estrogen, has been found to increase estrogen replacement therapy in an oral form has been found to increase lubrication of this area and has enhance arousal and sexual response. Viagra professional at cheap Canadian pharmacy. Again, this is based on very short term studies and longer term studies need to be looked at to see whether this is a placebo effect or not.