The number of women receiving dialysis treatment for kidney failure in the United States continues to increase. By the end of 2004, there were over 210,000 women receiving dialysis in the U.S. and the majority of these women were older than 50 years of age and likely menopausal when they initiated dialysis. The average age of the women on dialysis at the time menopause is 48; three years younger than the average age of when menopause starts for women in the general population. The average age of the women at the time menopause started was 48, three years younger than the average age of when menopause starts for women in the general population. Due to the risk of clotting the dialysis access, women who desire estrogen replacement for treatment of menopausal symptoms should consider transdermal estrogen to avoid the potential side effects of blood clotting.
For women receiving dialysis, starting doses of estrogen should be half the dose which would be used in a woman with normal kidney function. Other treatment options for menopausal symptoms include:
1. Gabapentin (anti-convulsant)
2. Clonidine (an anti-hypertensive medication)
3. Anti-depressants such as fluoxetine and sertraline.
However, these drugs are not as effective for treating severe menopausal symptoms as estrogen itself.
Vaginal atrophy, which may lead to painful sexual intercourse, is best treated with vaginal estrogen. Lubricants are also helpful to assist with vaginal dryness.
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