A viral trend claims that a mixture of frequent over-the-counter medicines, 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 lady’s early to mid-40s, although typically earlier. Menopause happens when a lady 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 ladies’s well being suggestion work — and is it secure?
I wished to know what the science exhibits and what ladies with menopausal signs ought to do to handle them, so I reached out to NCS wellness professional 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 trend, and the place did it come from?
Dr. Leana Wen: The trend you’re referring to includes 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 extensively on social media platforms, the place some ladies have reported enhancements in menopausal signs akin to scorching flashes, flushing, pores and skin itching and even low vitality and mind fog.
It’s necessary to word that the origin seems to come from anecdotal experiences and on-line communities, not from scientific journals and medical trials. These medicines are usually not authorised by the US Food and Drug Administration to deal with menopausal signs.
NCS: Is there any scientific foundation for utilizing these medicines to deal with signs of perimenopause or menopause?
Wen: There is a theoretical mechanism that some on-line influencers level to, which includes histamine, a chemical from the physique’s immune system that acts by 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 should contribute to flushing and itching in some circumstances, akin to 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 includes advanced interactions within the hypothalamus, not merely histamine pathways. I’m not conscious of any high-quality scientific proof within the type of medical trials displaying that antihistamines or famotidine are efficient therapies for menopause signs.
So, whereas the thought is biologically fascinating, it stays unproven. Anecdotal experiences shouldn’t be confused with rigorous scientific proof, and extra analysis is required to research how efficient these therapies are for menopause signs.
NCS: What signs are ladies hoping to relieve with this mixture?
Wen: The signs mostly talked about are scorching flashes, evening sweats and flushing. Some individuals 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, often 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 should happen a number of occasions a day or evening. They might interrupt sleep, and the girl might get up with the sheets soaked from sweating.
These signs will be fairly disruptive, which is why many ladies are searching for reduction and could also be drawn to over-the-counter choices that appear accessible and simple to attempt.
NCS: What are the potential dangers of taking these medicines for this objective?
Wen: Both allergy medicines and antacids are typically secure when used as directed for his or her supposed functions. However, utilizing them repeatedly and doubtlessly over lengthy durations for an unproven indication is completely different.
Antihistamines may cause unintended effects akin to drowsiness, dizziness, dry mouth and, in some instances, results on focus. While newer antihistamines are much less sedating than older antihistamines like diphenhydramine (generally bought as Benadryl), they aren’t fully free of those unintended effects. Famotidine can also have side effects, together with headache and gastrointestinal signs. Both medication might work together with different prescription and over-the-counter medicines, and I counsel sufferers who want to attempt them to examine with their major care clinician prematurely to be certain that it’s secure to accomplish that.
Which brings me to my different concern, which is ladies attempting these unproven therapies might delay searching for applicable medical care. If somebody depends on a viral trend as a substitute of consulting with a clinician, they might miss out on FDA-approved therapies which are recognized to be efficient.
NCS: How ought to ladies 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 lady has gone 12 consecutive months with out menstruating.
Symptoms for the 2 can differ extensively. In addition to the signs we mentioned earlier than, ladies might 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 help information remedy that addresses the underlying trigger.
NCS: What are evidence-based therapies for menopause signs that ladies ought to take into account?
Wen: The only remedy for average to extreme menopausal signs, notably 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 lady has a uterus. This remedy has been extensively studied and may considerably scale back signs. Multiple supply strategies can be found, together with drugs, patches, gels and sprays.
For these ladies who can’t or choose not to use hormone remedy, there are nonhormonal choices. Certain antidepressants have been proven to scale back scorching flashes. Other medicines, together with gabapentin and clonidine, may additionally be useful in some instances. The FDA has additionally not too long ago authorised some new medicines, particularly elinzanetant and fezolinetant, particularly for treating scorching flashes.
Lifestyle measures additionally may help. They embody sustaining a cool setting, dressing in layers, decreasing triggers akin to 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 every day functioning or if they’ve questions or issues about modifications of their menstrual cycle or general well being. They ought to go to their major care supplier; if wanted, they will additionally search specialist recommendation by 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 once they began, how usually they happen and the way they intrude with every day operate. Patients must also focus on their particular person well being historical past, together with danger elements for circumstances akin to heart problems or breast most cancers, which may affect remedy choices. If they’ve tried over-the-counter treatments, they need to make certain to point out them.
Patients ought to ask to focus on the total vary of remedy choices, together with hormone remedy and nonhormonal options. The aim is to have a customized plan that’s primarily based on proof and tailor-made to their particular wants.
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