Menopause And Hormone Replacement Therapy

By Ashley Henshaw. May 7th 2016

Menopausal hormone therapy was once a regularly prescribed treatment for the uncomfortable symptoms that tend to be associated with menopause. However, recent studies have shown that the risks of this type of therapy may outweigh the benefits. Learn more about what menopausal hormone therapy can do and when it should be used.

Benefits Of Hormone Therapy

There are two main types of menopausal hormone therapy, each of which offers its own unique benefits. These types of therapy include:

  1. Systemic hormone therapy: This treatment involves taking systemic estrogen in pill, gel, cream, spray or skin patch form. It is effective in relieving hot flashes and night sweats, which are two of the most common symptoms of menopause. It can also relieve vaginal symptoms of menopause, including dryness, burning, itching or discomfort during intercourse. It also helps to prevent osteoporosis.
  2. Low-dose vaginal estrogen products: These estrogen-containing products come in cream, tablet or ring form and help treat the vaginal symptoms of menopause listed above. In addition, they help with urinary symptoms like incontinence. Though these products don’t treat hot flashes or night sweats, or prevent osteoporosis, they reduce the amount of estrogen absorbed into the body when compared to systemic hormone therapy.

Risks Of Hormone Therapy

The early studies on hormone therapy for women going through menopause were promising. However, some of this research lacked sufficient evidence to tie hormone therapy to the benefits it was believed to cause. In July 2002, new findings arose from clinical trials which suggested that the long-term use of hormone therapy increases the risk of certain health conditions, including:

  • Blood clots
  • Heart disease
  • Stroke
  • Breast cancer
  • Gall bladder disease

When prescribed, hormone therapy often involves a combination estrogen-progestin pill. However, in some cases estrogen alone has been prescribed. The specific health risks posed by hormone therapy may depend on whether estrogen is taken alone or in combination with progestin and in what dosage. Other potential risks of hormone therapy may be affected by an individual’s age or their existing health risks for conditions like cardiovascular disease or cancer.

In addition to the long-term health risks, menopausal hormone therapy may also cause some immediate side effects, such as nausea, mood swings, headaches, vaginal bleeding, bloating and breast tenderness or swelling.

Who Should Get Hormone Therapy?

Though the information about the health risks of hormone therapy are more widely known at this point, systemic estrogen is still considered the most effective treatment for menopause symptoms and is still prescribed for certain individuals. Healthy, menopausal women who meet one of the following criteria are sometimes considered for hormone therapy:

  • Have severe hot flashes, night sweats or other menopause symptoms
  • Have lost significant bone mass and haven’t found success with other treatments
  • Experienced premature menopause (stopped having periods before the age of 40) or premature ovarian insufficiency (the ovaries stopped functioning normally before age 40)

Premature menopause can be especially dangerous for women who don’t use estrogen therapy because it can increase the risk of several serious health conditions, including dementia, osteoporosis, coronary heart disease and depression. The reason that menopausal hormone therapy is safer for women with premature menopause is because the earlier onset of menopause also decreases the risk for breast and ovarian cancer.

Reducing Risks

There are a few ways you can reduce the health risks associated with hormone therapy. Discuss the following strategies with your doctor before taking hormone therapy:

  1. Take the lowest dose possible for the shortest amount of time needed. Hormone therapy should be used only as a short-term treatment unless you experience menopause at a younger age.
  2. Use a product that reduces your body’s exposure to estrogen if possible. If you only experience vaginal symptoms related to menopause, then taking a low-dose vaginal estrogen product is preferable to taking systemic estrogen.
  3. See your doctor regularly. If you do use hormone therapy, seek follow-up care with your doctor to make sure the benefits are outweighing the risks. You should also schedule pelvic exams, mammograms and other health screenings regularly.
  4. Take steps to improve your overall health. Being healthy will decrease your risks for other health conditions. Exercise, maintain a healthy weight, eat right, don’t smoke, limit alcohol and manage stress for better overall health.

Alternatives To Hormone Therapy

Some women are able to manage their menopause symptoms by using the following techniques:

  • Avoid spicy foods, alcohol, hot weather and hot beverages to ward off hot flashes
  • Use vaginal lubricants or moisturizers to ease vaginal discomfort
  • Practice Kegel exercises to reduce urinary incontinence
  • Stay healthy by eating well, exercising regularly and not smoking
  • Use relaxation techniques or yoga to help with hot flashes

Menopause can be a difficult time for many women, so it’s understandable that they may want to use hormone therapy to relieve their symptoms. However, it’s best to try alternative techniques first to see if those are effective. If you find that alternative methods don’t relieve your menopause symptoms, or if you’re experiencing menopause early, talk to your doctor about the possible benefits of using hormone therapy and how it can be done safely.


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