Menopause is a natural stage in a woman’s life, but it can come with some unpleasant symptoms. For some women, taking certain antidepressants can help manage these symptoms when traditional hormone therapy such as estrogen therapy can’t be used. They can even help with those symptoms which aren’t mood related.
Understanding the Types of Antidepressants
Antidepressants are a class of drugs, as their name indicates, that are traditionally used to treat depression. Additionally, they can be used to treat other mental health issues such as Obsessive-Compulsive Disorder (OCD) and anxiety. These drugs are used in all cases by bringing the brain’s chemicals that control moods into balance, but not all antidepressants are the same, as there are four main types of antidepressants.
These types of antidepressants function by raising the brain’s serotonin levels, a chemical that carries messages between nerve cells in the brain to the rest of the body and can directly influence mood. By increase serotonin levels, SSRIs can help with mood improvement and, as surprising as it may seem, they unofficially may also be used to help decrease hot flashes and other menopausal symptoms.
Common SSRIs include:
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
These selective serotonin inhibitors are the most common when it comes to treating menopausal hot flashes and, according to researchers, forms or paroxetine in lower than normal doses are the only nonhormonal therapy that is specifically approved for hot flashes in the United States.
These function by raising the brain’s concentrations of both serotonin and norepinephrine, a neurotransmitter hormone.
Common SNRIs include:
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
In addition to depression, in some cases SNRIs are used to treat anxiety disorders and chronic nerve pain by increasing the neurotransmitters in the spinal cord that reduce pain signals.
These medications are of an older generation, some of the first antidepressants and thus, are not as frequently prescribed as SSRIs or SNRIs, although they function in relatively the same way, by changing the brain’s levels of serotonin and norepinephrine.
Examples of these include:
- Amitriptyline (Elavil)
- Desipramine (Norpramin)
- Imipramine (Tofranil)
In general, tricyclic antidepressants are used when other medications are unsuccessful to treat depression and mood disorders, however they are used in small doses to aid in treating migraines and chronic pain.
These original antidepressants prevent the body’s naturally produced levels of monoamine oxidase enzyme from degrading neurotransmitters like serotonin, norepinephrine and dopamine, which is used to send messages between nerve cells.
Examples of MAOIs include:
- Phenelzine (Nardil)
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)
Although these can help manage menopausal symptoms, MAOIs are rarely prescribed as they tend to have low tolerability, severe medication interactions, and can result in a number of serious side effects such as dangerously high blood pressure, prolonged nausea, insomnia, dizziness and diarrhea, to name a few.
Benefits of Antidepressants for Menopause
With the specifics aside, in general, antidepressants may reduce hot flashes, night sweats, and vaginal dryness, among other menopause-induced symptoms. Some studies have even shown that they can improve sleep quality and reduce fatigue.
In addition to the physical benefits, they can also have a positive impact on your mental health.
For many women, peri and post-menopause are accompanied by decreased estrogen levels, which can lead to various mental health problems. Some antidepressant usage can also help balance your hormone levels and improve your mental health, easing anxiety, depression, and mood swings, all of which can be a side effect of menopause.
Like all medications, side effects can vary and range in severity from person to person. Depending on the drug, there are different effects, but the most frequent ones include weight gain, erectile dysfunction, sleeplessness, and exhaustion. Additionally, some people might encounter gastrointestinal side effects like nausea and constipation. Although these side effects can be inconvenient, they usually disappear after a few weeks of treatment, once the body becomes use to the prescription.
In rare cases, patients may have more severe side effects such as mania (an abnormally elevated mood, inflated self-esteem, and decreased need for sleep) or serotonin syndrome, in which case the body produces too much serotonin, leading to high blood pressure, rapid heart rate, sweating, and confusion, and if not corrected this condition has the potential to be fatal.
If you experience any of these side effects, it is essential to stop taking the drug and seek medical attention immediately.
Risks of Taking Antidepressants for Menopause
While antidepressant usage for menopausal symptoms may be suggested, some research has suggested that SSRIs may increase the risk of osteoporosis. This is thought to be because SSRIs can interfere with the body’s absorption of calcium. Thus, for those taking an SSRI, it is essential to ensure enough calcium and vitamin D is received through the diet or supplements.
Additionally, some research suggests that these types of medication may be associated with an increased risk of breast cancer due to their ability to increase estrogen levels in the body.
It is also important to be aware that this medication may mask the symptoms of peri and post-menopause. This means that you may not realize you are experiencing menopausal symptoms until they become more severe.
While antidepressants may help some women during the various stages of menopause, they are not without risks.
Because of the severity of potential symptoms when used for non-depression cases, seeking additional non-estrogen treatments for menopausal symptom relief prior to turning to antidepressants is advised. These alternative remedies include lifestyle changes, such as getting regular exercise, practicing mindfulness, eating a healthy diet, and using natural plant extracts.
If you are considering antidepressant usage for treating menopause symptoms, speak with your doctor about the potential benefits and side effects. You should also be aware of the other non-estrogen treatments available for menopausal symptoms so that you can make the best decision for your individual needs.