By Katia Hetter, NCS
(NCS) — A viral pattern claims that a mixture of widespread over-the-counter drugs, particularly an allergy drug and an acid reducer, can ease signs of perimenopause and menopause.
Perimenopause is the transitional time main up to menopause, and it might start a number of years earlier than the ultimate menstrual interval, usually in a girl’s early to mid-40s, although typically earlier. Menopause happens when a girl has gone 12 consecutive months with out a menstrual interval, and the average age within the United States is round 52.
But again to the web: Does this viral girls’s well being suggestion work — and is it protected?
I needed to know what the science exhibits and what girls with menopausal signs ought to do to handle them, so I reached out to NCS wellness knowledgeable Dr. Leana Wen, an emergency doctor and adjunct affiliate professor at George Washington University. She beforehand served as Baltimore’s well being commissioner.
NCS: What is that this viral pattern, and the place did it come from?
Dr. Leana Wen: The pattern you’re referring to entails taking a mixture of an antihistamine, usually one thing like fexofenadine and cetirizine (generally recognized by their model names Allegra and Zyrtec, respectively), together with famotidine (generally recognized by model title Pepcid). This thought has unfold broadly on social media platforms, the place some girls have reported enhancements in menopausal signs resembling scorching flashes, flushing, pores and skin itching and even low power and mind fog.
It’s essential to word that the origin seems to come from anecdotal experiences and on-line communities, not from scientific journals and scientific trials. These drugs should not authorized by the US Food and Drug Administration to deal with menopausal signs.
NCS: Is there any scientific foundation for utilizing these drugs to deal with signs of perimenopause or menopause?
Wen: There is a theoretical mechanism that some on-line influencers level to, which entails histamine, a chemical from the physique’s immune system that acts via completely different receptors, together with H1 and H2 receptors. Antihistamines block H1 receptors, and famotidine blocks H2 receptors. Histamine can have an effect on blood vessels and will contribute to flushing and itching in some situations, resembling allergic reactions and mast cell activation syndrome, a situation that causes intense episodes of swelling, hives and different signs.
However, menopause symptoms are primarily pushed by modifications in estrogen ranges and the way these modifications have an effect on the mind’s temperature regulation system. This course of entails advanced interactions within the hypothalamus, not merely histamine pathways. I’m not conscious of any high-quality scientific proof within the type of scientific trials exhibiting that antihistamines or famotidine are efficient remedies for menopause signs.
So, whereas the concept is biologically fascinating, it stays unproven. Anecdotal experiences shouldn’t be confused with rigorous scientific proof, and extra analysis is required to examine how efficient these remedies are for menopause signs.
NCS: What signs are girls hoping to relieve with this mixture?
Wen: The signs mostly talked about are scorching flashes, night time sweats and flushing. Some folks additionally report enhancements in itching or pores and skin sensitivity, which may happen round perimenopause and menopause.
Hot flashes are fairly attribute of this life transition. They usually contain a sudden sensation of warmth, normally beginning within the chest or face and spreading outward, typically accompanied by profuse sweating, palpitations and nervousness. They can final from seconds to a number of minutes and will happen a number of instances a day or night time. They may interrupt sleep, and the lady could get up with the sheets soaked from sweating.
These signs could be fairly disruptive, which is why many ladies are in search of aid and could also be drawn to over-the-counter choices that appear accessible and straightforward to strive.
NCS: What are the potential dangers of taking these drugs for this objective?
Wen: Both allergy medicines and antacids are typically protected when used as directed for his or her meant functions. However, utilizing them commonly and doubtlessly over lengthy durations for an unproven indication is completely different.
Antihistamines could cause uncomfortable side effects resembling drowsiness, dizziness, dry mouth and, in some circumstances, results on focus. While newer antihistamines are much less sedating than older antihistamines like diphenhydramine (generally offered as Benadryl), they aren’t fully free of those uncomfortable side effects. Famotidine can also have side effects, together with headache and gastrointestinal signs. Both medicine may work together with different prescription and over-the-counter drugs, and I counsel sufferers who want to strive them to verify with their major care clinician upfront to be sure it’s protected to achieve this.
Which brings me to my different concern, which is girls making an attempt these unproven remedies could delay in search of applicable medical care. If somebody depends on a viral pattern as a substitute of consulting with a clinician, they could miss out on FDA-approved remedies which are recognized to be efficient.
NCS: How ought to girls assume about perimenopause and menopause extra typically?
Wen: As famous, perimenopause is the transitional step previous menopause, which could possibly be a number of years, whereas menopause refers to the precise time when a girl has gone 12 consecutive months with out menstruating.
Symptoms for the 2 can range broadly. In addition to the signs we mentioned earlier than, girls could expertise irregular durations, temper modifications, issue concentrating, vaginal dryness and modifications in libido. Some additionally report joint ache, fatigue and modifications in pores and skin and hair.
These signs are pushed by fluctuating hormone ranges, particularly declines in estrogen. Understanding that these physiologic modifications are regular may also help information therapy that addresses the underlying trigger.
NCS: What are evidence-based remedies for menopause signs that ladies ought to contemplate?
Wen: The only therapy for reasonable to extreme menopausal signs, significantly scorching flashes, is hormone therapy utilizing estrogen (additionally typically referred to as hormone alternative remedy), with or with out progesterone relying on whether or not a girl has a uterus. This remedy has been extensively studied and might considerably scale back signs. Multiple supply strategies can be found, together with tablets, patches, gels and sprays.
For these girls who can’t or desire not to use hormone remedy, there are nonhormonal choices. Certain antidepressants have been proven to scale back scorching flashes. Other drugs, together with gabapentin and clonidine, may additionally be useful in some circumstances. The FDA has additionally not too long ago authorized some new drugs, particularly elinzanetant and fezolinetant, particularly for treating scorching flashes.
Lifestyle measures additionally may also help. They embrace sustaining a cool setting, dressing in layers, decreasing triggers resembling alcohol and prioritizing good sleep hygiene.
NCS: When ought to somebody search medical recommendation for menopause signs, and what ought to they ask their clinician?
Wen: Women ought to search medical recommendation if their signs are affecting their high quality of life, interfering with sleep or each day functioning or if they’ve questions or issues about modifications of their menstrual cycle or total well being. They ought to go to their major care supplier; if wanted, they’ll additionally search specialist recommendation via a practitioner licensed by the Menopause Society who has particular experience in treating menopause and perimenopause.
It’s useful to come ready with a clear description of signs, together with after they began, how usually they happen and the way they intervene with each day perform. Patients also needs to talk about their particular person well being historical past, together with threat elements for situations resembling heart problems or breast most cancers, which may affect therapy choices. If they’ve tried over-the-counter cures, they need to make sure to point out them.
Patients ought to ask to talk about the complete vary of therapy choices, together with hormone remedy and nonhormonal alternate options. The objective is to have a personalised plan that’s primarily based on proof and tailor-made to their particular wants.
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