Mrs m asked
Can you get an estrogen cream on prescription from your doctor? I am on HRT & antidepressants for menopause. I am getting a lot of side affects with the antidepressants, just wondering if I come off both would the estrogen cream help a lot better? I have put weight on as well & it’s getting me really down along with the side effects. Please help if you can. Thanks in advance.
Answer
Estrogen creams are available with a prescription from your doctor. But changing to an estrogen cream and discontinuing the antidepressant might leave some symptoms of menopause untreated.
Menopause Symptoms
There are three categories of menopause symptoms:
- Vasomotor symptoms
- Vulvovaginal symptoms
- Psychological symptoms
Vasomotor
Vasomotor symptoms include:
- Hot flashes
- Night sweats
- Headache
- Insomnia/sleep disturbances
Vulvovaginal
Vulvovaginal symptoms include:
- Vaginal dryness
- Painful sexual intercourse
- Vaginal itching/burning
- Urinary tract infections
- Changes in urination habits (like having to pee more, feeling the urgency to pee, or peeing less)
Psychological
Psychological symptoms include:
- Anxiety
- Irritability
- Depression
- Fatigue
- Reduced sexual desire/arousal
- Cognitive difficulties
- Backaches or back stiffness
Hormone replacement therapy (HRT), such as from estrogen creams, is used to treat vasomotor and/or vulvovaginal symptoms.
Antidepressants are used to treat psychological symptoms. However, there are times where hormone replacement therapies can also help with the psychological symptoms as well.
If you are experiencing unwanted side effects with the antidepressant, you can talk to your doctor about switching to a different drug that does not cause as much weight gain. It is possible to change to a drug in the same class or to a drug in a different class that might not have the weight gain side effect.
Estrogen Creams
In regard to estrogen creams, they are only available by prescription by may be a good option for many post-menopausal women. Available creams include:
- Estrace Vaginal Cream
- Divigel Transdermal Gel
- Elestrin
- Estrogel
- Evamist (estrogen transdermal spray)
- Premarin
As mentioned above, estrogen creams can be useful for treating both the vasomotor (e.g. hot flashes) and vulvovaginal symptoms (e.g. painful intercourse) symptoms of menopause. There generally isn't one preferred product and little data of compared efficacy and safety between them. The choice of product is mostly based on doctor/patient preference, cost
Additional Information
There are also non-drug therapies to help with psychological symptoms including psychotherapy, relaxation and stress reduction techniques, and lifestyle modifications (like exercising and changing your diet).
Changing from an oral HRT agent to a topical agent like an estrogen cream might help with unwanted side effects from the oral HRT agent but this may not relieve the side effects from the antidepressant.
Discontinuing the antidepressant altogether might leave some of your menopause symptoms untreated. Talk to your doctor about switching to a different antidepressant agent that does not have as many side effects as your current medication.
