Question: “Hello, I am 49 years old and am having problems with menopause, hot flashes, night sweats, irritability, not sleeping well, emotional, fatigue, weight gain. When I went to the doctor she seemed to think that Citalopram 20 mg will help me feel better, feel less fatigued, have more energy etc. I’m really not happy with taking an antidepressant; is the doctor correct in giving me this drug? Also I am having liver problems, which I’m seeing a specialist about, and am going through tests right now.”
First, let me state that Citalopram and other antidepressant medications are toxic. This is the last thing your liver needs.
Secondly, Menopause is the complete shutting down of the female reproductive system. The menopause transition, and post-menopause itself, is a natural life change, not a disease state or a disorder. Has your estrogen levels been tested or treated? Has your thyroid been tested? This is the age where women often run into difficulties with their thyroid which can present similiar symptoms to menopause. Have you had a physical lately? Sometimes doctors take your word for a self-diagnosis because it sounds to fit, but in reality your symptoms could be caused from other things other than menopause, though at your age it is the first thing suspected. This is how other problems get overlooked. It happened to me, but luckily because of insistence for blood testing my problem was detected. Have you had a recent pelvic exam? You are also at the age when some women develop Fibroids.
Thirdly, this medication has 81 possible side effects (see below). Your body is not doing well because it is lacking something. It already has inflammation. Adding toxic medications will only exasperbate this inlammation, adding additional symptoms.
Fourthly, if you should miss dosages or decide to stop taking Citalopram you could face very unpleasant withdrawal symptoms (also listed below).
Menopause symptoms worsen with stress. Life already has stresses such as bills, jobs, children, spouses, relatives, etc., but things can only get worse when you are faced with side effects such as sexual dysfunction, insomnia and a general feeling of being drugged and not being able to think straight or react quickly.
This article provides you with an extensive list of side effects, withdrawal symptoms and some alternative treatments.
Citalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). It is sold under the brand-names Celexa (U.S. and Canada, Forest Laboratories, Inc.), Cipramil (Australia), Citrol, Seropram,Talam (Europe and Australia), Citabax, Citaxin (Poland), Citalec (Slovakia), Recital (Israel, Thrima Inc. for Unipharm Ltd.), Zetalo (India), Celapram, Ciazil (Australia), Zentius (South America, Roemmers), Ciprapine (Ireland), Cilift (South Africa) and Cipram (Denmark, H. Lundbeck A/S).
CELEXA (CITALOPRAM, GENERIC NAME) – SIDE EFFECTS
Anorexia – No longer having a desire to eat.
Apothous Stomatitis – Painful red and swollen open sores on a mucus membrane of the mouth commonly called a canker sore.
Ataxia – Loss of the ability to move the body with coordination.
Arterial Fibrillation – A condition of abnormal twitching of the muscles in the blood vessels that moves the oxygenated blood from the heart to the rest of the body. The unusual twitching is rapid and irregular and replaces the normal rhythm of contraction of the muscle, which sometimes causes a lack of circulation and pulse
Blood Cholesterol Increased – An abnormal condition where there is a greater amount in the blood of the oily/fatty substances known as cholesterol. Cholesterol is a necessary part of living cells (along with proteins and carbohydrates). Because cholesterol only slightly dissolves in water, it can build up on the walls of the blood vessels, therefore blocking/decreasing the amount of blood flow, which causes blood pressure to go up. If not corrected, this condition is associated with coronary artery disease.
Blood Creatinine Increased – A greater than normal number of creatinine or muscular chemical waste molecules in the blood. Creatinine plays a major role in energy production in muscles. Since creatinine levels are normally maintained by the kidneys, Blood Creatinine Increased is an indicator of kidney malfunction or failure.
Blood in Stool – The blood that is in your bowel movement usually comes from any place along your digestive tract (from your mouth to your anus). The stool can appear black and foul-smelling (usually from the upper part of your digestive tract) or red or maroon-colored (usually from the large intestine area). Hemorrhoids are the usual cause for blood in the bowels.
Bundle Branch Block Right – These are specialized cells in the upper right heart chamber and are the heart’s pacemaker. They send electrical signals to the heart that keeps it beating or contracting regularly. Normally the signal goes to the lower heart chambers at the same time through the bundle of His (hiss) on both the left and right sides of the heart, so the lower chambers contract at the same time. When the bundle is damaged on the right side, the signal does not fire at the same time as the left, which changes the pace of blood flow. This can lead to a person fainting.
Cardiac Failure – A heart disorder where the heart does not function as usual and may completely stop working.
Cardiac Failure Congestive – The body is asking for the heart to supply more blood than it is capable of producing and maintaining. Normally, a body can tolerate an increased amount of work for quite some time. The condition is characterized by weakness, shortness of breath, and a fluid build-up in the body tissues causing swelling.
Cold Sweat – The skin is clammy and moist and you feel chilled. This is a reaction to a shock or pain as well as to fear and nervousness.
Colitis – A condition where the large intestine becomes irritated from the use of the drug.
Coronary Artery Disease – A condition where the blood vessels that mainly carry the blood away from the heart become clogged up or narrowed usually by fatty deposits. The first symptom is pain spreading from the upper left body caused by not enough oxygen reaching the heart.
Dehydration – An extreme loss of water from the body or the organs of the body as in sickness or not drinking enough fluids.
Diplopia – The condition where a person is looking a one object and instead of normally seeing just the one object he sees two. This is also call double vision.
Diverticulitis – There are pouches or sacs on the inside of the intestines that look like fingers. This increases the area for the body to absorb nutrients as they pass through the intestines. These sacs become irritated and swollen and end up trapping waste that would normally be eliminated, causing pain and constipation.
Dysarthria – The inability to control the mouth muscles when forming words so the words are not clearly spoken and heard.
Dyslipidemia – The normal fat metabolism in the blood is interfered with.
Dysphagia – Trouble swallowing or the inability to swallow.
Ecchymosis – When a blood vessel breaks and creates a purple discoloration of the skin.
Edema - An abnormal build up of excess fluids in the cells, tissues, and the spaces between the tissues creating swelling.
Edema Peripheral – The abnormal build up of fluids in the tissues of the ankles and legs causing painless swelling in the legs, ankles, and feet. If you squeeze the swollen area it leaves an indentation on the skin for a few minutes.
Ejaculation Delayed – The man is not able to release sperm either during sexual intercourse or with manual stimulation in the presence of his sexual partner in spite of his wish to do so.
Ejaculation Dysfunction – A condition where the man has one or more of the following symptoms: He is not able to have an erection, not able to have an orgasm, has a decreased interest in sex, is sexually inhibited, or it is painful to ejaculate sperm.
Erectile Dysfunction – Incapable of having sexual intercourse. Even though a man desires sex he is inhibited in his sexual activity and is unable to have or maintain an erection of the penis.
Erythema – a skin redness caused by the swelling with blood of the tiny blood vessels of the skin as in burns.
Erythematous Rash – Redness of the skin from the swelling of the tiny blood vessels with skin irritation (itching, burning, tingling, pain) and breakouts (eruptions).
Esophageal Stenosis Acquired – The tube that moves food from the mouth to the stomach narrows.
Exfoliative Dermatitis – The unusual and not normal condition of scaling and shedding of the skin cells. The skin is usually red colored.
Face Edema – The tissues of the face become swollen.
Feeling Jittery – A physical sensation of nervous unease.
Gastric Irritation – An inflamed and sore stomach.
Gastric Ulcer – An open, irritated, and infected sore in the wall of the stomach.
Gingivitis – Sore, swollen and red gums in the mouth that bleed easily.
Glaucoma – The delicate nerve to the eye, the optic nerve, becomes easily damaged with the build-up of excess fluid pressure within the eyeball. The first sign of glaucoma is loss of peripheral (side) vision. It can progress to total blindness.
Hepatic Steatosis – Excessive amounts of fat in the liver.
Hyperhidrosis – The triggering of an excess of sweat being produced on the soles of the feet, the palms, or the underarms which can cause embarrassment or losing grip on a pen or other items.
Hyperkeratosis – An abnormal enlargement of the skin tissues causing the skin cells to increase in size.
Hyperlipidemia – An abnormally high number of fat cells in the blood.
Hypertriglyceridemia – Too many triglycerides in the blood. (Triglycerides are three fatty acids bound together in one molecule stored by the body and available to create high levels of energy when used.)
Hypoesthesia – A partial loss of sensation or general loss of awareness.
Impaired Gastric Emptying – The contents of the stomach are not passed into the intestines as normal due to the stomach losing the muscular strength to do so.
Increased White Blood cell Count – This is an increase in the number of cells in the blood that are responsible for the removal of bacteria and other unwanted particles. They fight disease and infection by enclosing foreign particles and removing them. An example of a disease that would increase white blood cell count would be Leukemia.
Insomnia – Not able to fall asleep or sleeping for a shorter time than desired, thus not being able to properly rest and feeling un-refreshed. As a result, a person can become irritable, have difficulty concentrating and feel a lack of energy. This can be caused by stimulants such as by caffeine or drugs or by mental anxiety and stress. Mental stress can be communicated and relieved.
Irritable Bowel Syndrome – A painful condition where the either the muscles or the nerves of the lower intestines, are not responding normally. This results in an alternating condition of diarrhea followed by constipation, back and forth.
Keratoconjunctivitis Sicca - A condition where the outer coating of the eyeball is dry because of a decrease in the normal amount of tears in the eye. As a result, the eyeball and inside of the eyelid thickens and hardens sometimes causing the vision to be less sharp.
Leukopenia – An unnaturally low number of white blood cells circulating in the blood.
Loose Stools – The bowel movement is runny instead of formed.
Lower Abdominal Pain – A hurtful irritation of the nerve endings in the area of the hipbones housing the lower digestive tract. Pain usually means tissue damage.
Lymphadenopathy – The lymph nodes, where the immune cells are located, become larger than is normal because of a high concentration of white blood cells.
Macular Degeneration – The gradual loss of central vision, which is the sharpest vision while peripheral eyesight, is unaffected.
Maculopathy – An abnormal condition of the yellow spot of the eye, which is located in the center of the inner lining of the eyeball and connected to the main nerve to the eye and is responsible for sharp vision.
Mania – Unusually irrational, excessive and/or exaggerated behavior or moods ranging from enthusiasm, sexuality, gaiety, impulsiveness and irritability to violence.
Melena – Abnormally darkly colored stools as a result of hemorrhaging in the digestive tract where the blood has interacted with the digestive juices creating the dark color in the bowel movement.
Micturition Urgency – A sudden desire to urinate usually followed by leakage.
Mood Swings – An emotional shifting as from a state of happiness to a state of depression for a period of time.
Myocardial Infarction – The blood going to the heart is delayed or stopped causing middle muscle tissue in the heart wall to die.
Nasopharyngitis – Irritation, redness and swelling tissues in the nose and the tube leading from the mouth to the voice box as well as the tubes leading to the ears.
Nephropathy – An abnormally functioning or diseased kidney.
Nervousness – Jumpy, jittery, anxious, and troubled with an irritable temperament.
Night Sweats – The water-salt, waste product the skin releases is called sweat or perspiration. With night sweats you become wide awake in the middle of the night shivering and cold and wet with your sheets/pajamas soaked in perspiration making it difficult to go back to sleep.
Nightmare – Dreams that make you afraid or leave feelings of fear, terror, and upset long after waking up.
Orgasm Abnormal – Unable to have an orgasm with normal sexual stimulation.
Oropharyngeal Swelling – A swelling in the area from the soft part of the roof of the mouth to the back of the mouth.
Pain in Extremity – A painful feeling in the legs, arms, hands, and feet.
Pharyngolaryngeal Pain – Pain in the area of the respiratory tract (organs of breathing) from the throat to the voice box and above the windpipe.
Photopsia – A condition where a person see lights, sparks or colors in front of your eyes.
Photosensitivity Reaction – An exaggerated sunburn reaction that is not normal in proportion to the amount of exposure to the light.
Pollakiuria – Urinating much more frequently than normal – as often as once every five to fifteen minutes.
Pressure of Speech – A condition where the individual cannot voice his ideas fast enough with the pressure of there being not enough time to say it.
Pruritic Rash – Extremely itchy, red, swollen bumps on the skin.
Pyrexia – Fever or the increase in body temperature that is usually a sign of infection.
Retinal Detachment – The thin layer lining the back of the eyeball (the retina) detaches from the back of the eyeball. This thin layer is like the film of a camera because it sends the images a person views to the brain. When it detaches it causes a reduced ability to see.
Rigors – Shivering or shaking of the body as if chilled, preventing normal responses.
Skin Ulcer – An open sore or infected skin eruption with swelling, redness, pus, and irritation.
Sleep Disorder – These are a list of sleep disorders such as teeth grinding, insomnia, jet lag, sleep walking, abnormally falling asleep during the middle of a conversation after a full night’s rest, uncontrolled body motions keeping one awake, etc.
Suicide, Completed – An attempted attack on oneself that is life threatening results in death.
Upper Respiratory Tract Infection – Where the organs of breathing near the mouth such as the nose and sinuses, become infected and are usually treated by antibiotics.
Urinary Hesitation – Hard to start or hard to continue emptying one’s bladder.
Urinary Incontinence – Urinating without intending to do so because of a weakening of the muscles in the hip area from the drug affecting the nerves or the drug blocking a persons thinking process.
Urinary Retention – The inability to completely empty the bladder despite having the urge to do so. This can lead to infections or damage to the urinary organs.
Urine Flow Decreased – Dehydration of the body causing a lesser flow of urine than normal with the body reabsorbing the waste.
Urine Output Decreased – A condition where the output of urine produced in a 24-hour period is less than 500 ml.
Weight Decreased – Unintentional weight loss.
Aggression, anxiety, balance issues , blurred vision , brain zaps, concentration impairment, constipation, crying spells, depersonalization, diarrhea, dizziness. electric shock sensations, fatigue, flatulence, flu-like symptoms, hallucinations, hostility, highly emotional, indigestion, irritability, impaired speech, insomnia, jumpy nerves, lack of coordination, lethargy, migraine headaches / increased headaches, nausea, nervousness, over-reacting to situations, paranoia, repetitive thoughts or songs, sensory & sleep disturbances, severe internal restlessness (akathasia), stomach cramps, tremors, tinnitus (ear ringing or buzzing), tingling sensations, troubling thoughts, visual hallucinations / illusions, vivid dreams, speech visual changes, worsened depression
The Standard Medical Treatment:
In 1998, the #1 prescription drug in the U.S. was Premarin (estrogen from horse urine). Side effects include increased risk of uterine cancer when used without concurrent use of progesterone , stroke, and a 26% increased risk of breast cancer. Hormonal Therapy, whether it be estrogen, progestin or testosterone, are leading drugs and more are on the way. In a survey recently, it was estimated that there are over 300 drugs in work that are designed specifically for women. To make us buy, they will claim to know us better than we know ourselves. In a USA TODAY article, dating back from 2000, the press reported and acknowledged: “Women do not want to be on Hormonal Drugs!”
Black Cohosh The most widely used and thoroughly studied natural supplement for the management of menopausal symptoms is the herbal agent known as black cohosh, cimifuga racemosa, that must be standardized to 2.5% triterpene content. Four major human studies have demonstrated the ability of black cohosh to help manage menopausal signs and symptoms. In the first open study involving 131 physicians who together recruited 629 female patients, 80% of patients experienced improvement of physical and psychological symptoms associated with menopause, within 6-8 weeks of treatment with black cohosh extract. Significant improvement was noted in hot flashes, profuse sweating, headache, vertigo, heart palpitations, tinnitus, nervousness and irritability, sleep disturbances and depressive moods. Only 7% of patients reported mild transitory stomach complaints.
Soy isoflavones Soy extract, yielding a minimum of 50 mg of soy isoflavones, has been shown to reduce hot flashes and other menopausal symptoms in various clinical trials. Some studies show up to a 40% reduction in hot flashes with the use of soy isoflavone products. Soy isoflavones also possess phytoestrogen activity-plant-based estrogen. Like the triterpene saponins found in black cohosh, soy isoflavones are a type of Selective Estrogen Receptor Modulator, or SERM, that preferentially stimulates beta estrogen receptors on reproductive and other tissues. In turn, this provides weak estrogenic support to reproductive tissue and bones, without over-stimulating breast and endometrial cells, as may HRT. HRT stimulates the alpha-receptors on breast tissue that increases their rate of cell division and the likelihood of developing cancerous mutations. Stimulation of the beta-receptors by soy isoflavones and black cohosh triterpenes has been shown to slow down the rate of cell division of breast and endometrial cells in the presence of the body’s own estrogen; an effect associated with a decreased risk of reproductive cancers.
It also should be noted that soy products and soy extract supplements are known to reduce blood cholesterol levels by 9-12% in patients with high cholesterol levels.9 The same is true for a supplement known as gamma-oryzanol that is derived from rice bran oil. Both soy extract and gamma-oryzanol have been shown to reduce hot flashes and other menopausal symptoms and are excellent alternative therapies to the use of HRT in postmenopausal women. Gamma-oryzanol is an approved drug for the management of menopausal symptoms in Japan, where the research on this natural agent has been performed. It is very convenient that soy extract and gamma-oryzanol can help reduce menopausal symptoms, reduce cholesterol levels, and in the case of soy isoflavones, help to maintain bone mineral density.
Caution is advised in using any soy product. Many soy products are genetically engineered. Since no one knows the effects of genetically engineered products, it is best to purchase products that state “not genetically engineered” and even then there is no guarantee that it is not.
In summary, as a natural alternative to hormone replacement therapy, the standardized grade of Black Cohosh, Soy extract and Gamma-oryzanol have demonstrated a proven ability to control menopausal signs and symptoms, maintain sexual function, support bone health and even lower cholesterol levels (heart disease is the number one killer of postmenopausal women) in postmenopausal females.
In summary, the combination of Black Cohosh, Soy isoflavones and Gamma-oryzanol (at the therapeutic dosage and grade of each nutrient) is an effective alternative to hormone replacement for many postmenopausal women (who do not have existing osteoporosis) and can help tone down the over stimulation to breast and uterine tissues in women who have advanced osteoporosis. Evidence suggests that this nutrient combination can also be used to help control uterine fibroids, fibrocystic breast disease and endometriosis. For more information about these applications in your case, speak to your health practitioner
The decline in estrogen levels that accompanies the menopausal years also permits calcium to leak out of bone into the blood stream where it eventually will become filtered by the kidney and exit the body in the urine. This, of course, leads to osteoporosis that increases risk of fractures. Osteoporosis is reaching epidemic proportions in our society largely due to insufficient calcium intake and accumulation in bone, especially between ages 11 and 24, and loss of calcium from bone during the menopausal years.16,17 It should be noted that Canadian statistics indicate that complications from osteoporotic hip fractures, such as the development of pneumonia, result in more deaths each year than the combined mortality rate from breast and ovarian cancers.18 The lifestyle recipe to prevent osteoporosis during the menopausal years is as follows:
- Ingest 1,500 mg per day of calcium, if not taking HRT. This can be through a combination of calcium from diet and supplements. Calcium carbonate and calcium citrate are absorbed equally as well if taken with meals. Calcium carbonate represents a more cost-effective intervention for patients because it is less expensive. However, if the patient has had a previous history of kidney stones, calcium citrate may be preferred due to its greater solubility.
- Both Magnesium and Vitamin D help metabolize calcium. 600-1,000 IU of vitamin D is sufficient. For general health reasons women should consider taking a high-potency multiple vitamin and mineral that normally includes 400 IU of vitamin D. Studies show that postmenopausal women ingesting an additional 200 to 400 IU of vitamin D per day may reduce their risk of hip fractures by approximately 50%. A high potency multiple vitamin and mineral, including extra antioxidant protection and a B-50 complex, will contain other nutrients important to bone health such as calcium zinc, magnesium and copper.
- With age, the kidneys reduce their ability to convert 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D that is twice as powerful a form of vitamin D than is 25-hydroxyvitamin D. However, studies indicate that by increasing blood levels of 25-hydroxyvitamin D through the intake of 600-1,000 vitamin D supplements per day, a postmenopausal women can compensate for the drop off in 1,25-hydroxyvitamin D synthesis, and thereby significantly reduce her risk of osteoporotic fractures.
- Perform weight-bearing and/or resisted exercises 4-7 times per week. Weight bearing exercise such as walking or jogging, and weight training exercises, place increased stress on the spine and femurs that respond by holding their calcium in bone to help withstand the physical stresses acting on the bone structures. Some studies reveal that postmenopausal women can increase their bone density, without using HRT, by simply ingesting more calcium and performing a series of five weight training exercises, twice per week.
- Supplement with a product that contains black cohosh and soy isoflavones. As will be discussed later, the standardized grade of black cohosh and soy extract have been shown to reduce menopausal symptoms and evidence exists to show that they also can help to preserve bone mineral density via their estrogenic effects on bone receptors.
There are also natural hormones that are best obtained from a qualified doctor. Never self-medicating with them because you can cause such things as thinning the lining of your uterus causing hemorrhaging and more. Stay tuned for future articles on this topic.
Update: I stopped drinking soy milk because of all the bad things that I read about it. I heard that soy milk creates the bad kind of estrogen that causes cancer and that the good kind of soy are soy isoflavons. I also heard that 90 – 95% of soy products are GMO (genetically engineered). I stopped the soy milk consumption which was around 12 oz. a day which contains about 60 mg. of soy isoflavons. Then my hot flashes came on severely. Then I purchased some soy isoflavans online and it is really helping. I purchased a brand that has 70 mg of soy isoflavons if you take 4 capsules daily. I usually only remember to take 2 a day, but I know the hot flashes would probably go away if I took all 4. I never forget to take that bedtime one, though. I ensure a restful night’s sleep. Good luck!
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