To help EP cope with vasomotor symptoms of menopause and prescribe effective treatment, it is important to collect additional information regarding any vaginal symptoms. Furthermore, it is necessary to ask about reasons for taking omeprazole to prevent prescribing medications that can cause any effects on the patient’s gastrointestinal tract. Before deciding on the most appropriate medication and treatment plan, it is important to focus on such variables as the patient’s past medical history, recently worsened vasomotor symptoms, her blood pressure that is higher than normal, her BMI, and the patient’s desire to avoid the hormonal treatment.
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The recommended pharmacological treatment should be based on taking paroxetine. Currently, the EP takes 20 mg of paroxetine daily, but it does not provide expected effects. In this case, it is possible to recommend increasing the dose to 30 mg/day according to the guidelines (American College of Obstetricians and Gynecologists, 2014). Paroxetine should be taken in the form of oral 30 mg immediate-release tablets (1 tablet daily, in the morning).
The continuation of the therapy is chosen because paroxetine as a selective serotonin reuptake inhibitor is recommended by the specialists of the American College of Obstetricians and Gynecologists. Paroxetine has fewer side effects than other non-hormonal medications, such as clonidine and gabapentin. It will be possible to increase the dosage to 40 mg/day if necessary without significant adverse effects, including nausea and constipation (Orleans et al., 2014). If there are vaginal symptoms, it will be important to educate the patient regarding the benefits and disadvantages of low-dose vaginal estrogen as there are a few non-hormonal alternatives.
Non-pharmacological treatment should be based on keeping to a low-fat diet to lose weight and normalize the blood pressure. The patient should be educated regarding the advantages of eating products with phytoestrogens and avoid consuming caffeine, alcohol, and spicy foods (Orleans et al., 2014). Moderate exercising and yoga are viewed as effective approaches to coping with vasomotor symptoms.
American College of Obstetricians and Gynecologists. (2014). Practice bulletin no. 141: Management of menopausal symptoms. Obstetrics and Gynecology, 123(1), 202-216.
Orleans, R. J., Li, L., Kim, M. J., Guo, J., Sobhan, M., Soule, L., & Joffe, H. V. (2014). FDA approval of paroxetine for menopausal hot flushes. New England Journal of Medicine, 370(19), 1777-1779.