Hormone Alternatives (Prescription Medications are CAPITALLIZED) Hot Flashes: CLONIDINE 0.1 mg three times a day by prescription only—could rarely cause dizziness. SSRI’s (such as FLUOXITINE) and EFFEXOR are reported to help hot flashes. Black cohosh and traditional Chinese herbal preparations, soy food, or acupuncture are also options. Vaginal Dryness or Irritation: Small doses of vaginal estrogen such as VAGIFEM or estradiol vaginal cream will help these symptoms and won’t raise blood estrogen levels Osteoporosis prevention/treatment: Prevention: EVISTA (an estrogen receptor agent, not a hormone), (bone re-building agents), Calcium 1200mg per day, Vitamin D 400 units per day, walking, may add FOSAMAX or ACTONEL (bone rebuilders) for treatment Cholesterol or blood lipid elevation: Lipid lowering agents such as LIPITOR Sleep Disturbance: SONATA or AMBIEN—use 3 times per week; if taken every night may stop working PMS or Anxiety/Depression: Serotonin activity medications such as FLUOXITINE or EFFEXOR, acupuncture Muscle Cramps: Quinine: drink ½ cup of tonic water (contains quinine) at bedtime Traditional Chinese Herbs or Acupuncture are available for many symptoms: Our staff can devise and offer specific treatments.