Selective Estrogen Receptor Modulators
SERMs are a category of drugs, either synthetically produced or derived from a botanical source (Phytoserms), that act selectively as agonists or antagonists on the estrogen receptors throughout the body. The most commonly prescribed SERMs are raloxifene and tamoxifen. Raloxifene exhibits oestrogen agonist activity on bone and lipids, and antagonist activity on breast and the endometrium.Tamoxifen is in widespread use for treatment of hormone sensitive breast cancer. Raloxifene prevents vertebral fractures in postmenopausal, osteoporotic women and reduces the risk of invasive breast cancer. While most SERMs are known to increase hot flushes, Femarelle (DT56a) decreases them. In addition to the relieving effects on menopausal symptoms, Femarelle also increases bone mass density (BMD), making it protective against osteoporotic fractures. These effects are achieved by an agonistic interaction with estrogen receptors in the brain and bone. On the other hand, an antagonist interaction with estrogen receptors in the breast and uterus, has no effect on these tissues.
Antidepressants such as paroxetine (Paxil), Fluoxetine hydrochloride (Prozac), and Venlafaxine hydrochloride (Effexor) have been used with some success in the treatment of hot flashes, improving sleep, mood, and quality of life. Paroxetine and venlafaxine may cause nausea and insomnia. In addition, venlafaxine may cause dry mouth, constipation and decreased appetite whereas paroxetine may cause headaches. There is a theoretical reason why SSRI antidepressants might help with memory problems: they increase circulating levels of the neurotransmitter serotonin in the brain and restore hippocampal function. Fluoxetine hydrochloride (Sarafem) is also prescribed for premenstrual dysphoric disorder (PMDD), a mood disorder often exacerbated during perimenopause. PMDD has been found by PET scans to be associated with dysregulation of serotonin pathways in the brain and to respond quickly and powerfully to SSRIs.
Gabapentin (sometimes called by its brand name, Neurontin) and other GABA analogs are anti-seizure medications. Several GABA analogs are prescribed off-label for a variety of other conditions (such as pregabalin being used to treat the symptoms of fibromyalgia under the brand name Lyrica); gabapentin itself has been shown to be as effective as estrogen at reducing hot flashes.
Blood pressure medicines
Blood pressure medicines including clonidine (Catapres) are about as effective as antidepressants for hot flashes, but do not have the other mind and mood benefits of antidepressants. However they may merit special consideration by women suffering both from high blood pressure and hot flashes.
Patients taking Viagra are less likely to suffer a heart attack, new research claims.
Men taking the impotence drug were found to have a lower risk of having a heart attack or dying from heart failure than those not on the medication.
The findings mean Viagra could soon be used to treat hundreds of thousands of heart failure patients and even prevent fatal heart attacks, scientists say.
Experts from the University of Manchester studied 6,000 diabetic patients who had been given Viagra to treat erectile dysfunction.
The drug relaxes muscle cells in the blood vessels supplying the penis, allowing more blood to flow there.
This increased blood flow increases the likelihood of getting an erection.
Given the increasing reports of deaths in which the use of Viagra may be implicated, clinicians need to exercise caution when advising their patients with heart
Experts believe a key ingredient in Viagra called PDE5i, which relaxes blood vessels, also prevents damage to heart cells.
Heart failure is caused by the heart failing to pump enough blood around the body at the right pressure.
It most often occurs because the heart muscle has become too weak or stiff to work properly and is usually treated with medication which supports the heart.
Despite diabetics being prone to heart problems, the study participants did not suffer as many incidents as similar patients not on the drug.