Have you ever heard of menopausal hormone therapy? It replaces estrogen that the body does not produce during menopause. Hormone therapy is often used to treat common menopausal symptoms, including hot flashes and vaginal discomfort. In addition to its benefits, menopausal hormone therapy can sometimes have risks. Of course, these risks depend on the type of hormone therapy, dose, duration of medication and health status of the person. In this article we will talk in detail about menopausal hormone therapy and its benefits and risks.
Types of menopausal hormone therapy
Hormone therapy is primarily aimed at replacing estrogen that the body no longer produces after menopause. There are two main types of estrogen therapy:
1. Systemic hormone therapy
In this type of hormone therapy, estrogen enters the bloodstream in the form of pills, gels, creams or sprays and affects all parts of the body. This type of estrogen therapy can be used to treat all the common symptoms of menopause.
۲. Hormone therapy with low-dose vaginal products
Vaginal estrogen medications are in the form of creams, pills, or rings that minimize the amount of estrogen absorbed by the body. For this reason, low-dose vaginal estrogen is usually used only to treat vaginal and urinary menopausal symptoms.
If you do not have a uterus, your doctor will usually prescribe estrogen along with progesterone or progestin, because when estrogen is not balanced with progesterone, it may stimulate the growth of the lining of the uterus and increase the risk of endometrial cancer. If the person has had their uterus removed (hysterectomy), you may not need to take progesterone.
What are the benefits of menopausal hormone therapy?
Some of the most important benefits of menopausal hormone therapy are:
- Eliminates hot flashes and night sweats;
- Helps a person sleep better;
- Relieves dryness and itching of the vagina;
- Reduces discomfort and pain during intercourse;
- Prevents osteoporosis;
- Makes some women less likely to develop heart disease;
- Reduces the risk of dementia.
Who is hormone therapy suitable for?
If a person is healthy, the benefits of hormone therapy will probably outweigh the risks:
1. Moderate to severe hot flashes
Systemic estrogen therapy is the most effective treatment for menopausal hot flashes and night sweats.
۲. Other symptoms of menopause
Estrogen can reduce the symptoms of vaginal menopause such as dryness, itching, burning and discomfort caused by sex.
3. Need to prevent bone loss
Systemic estrogen protects against osteoporosis. However, doctors usually prescribe drugs called bisphosphonates to treat osteoporosis. Estrogen therapy can be helpful if a person cannot tolerate treatment or other medications do not work.
4. Premature menopause or estrogen deficiency
In premature menopause, the body has less estrogen than in normal menopause:
- The person had surgery to remove their ovaries before the age of 45;
- Menstruation has stopped before the age of 45 (premature menopause);
- Normal ovarian function is impaired before the age of 40 (premature ovarian failure).
In these cases, estrogen therapy can reduce the risk of some diseases, including:
- Heart disease;
- Mood swings.
What are the risks of menopausal hormone therapy?
In the largest clinical trial to date, hormone replacement therapy with estrogen progesterone (Prempro) pills increased the risk of some serious diseases, including:
- Heart disease;
- blood clotting;
- Breast Cancer.
However, subsequent studies have shown that the side effects of menopausal hormone therapy vary depending on the following:
- Age: Women who start menopausal hormone therapy at age 60 or older or more than 10 years after menopause are at higher risk. But if hormone therapy is started before age 60 or shortly after menopause, the benefits seem to outweigh the risks.
- Type of hormone therapy: The risks of hormone therapy vary depending on the dose and type of estrogen and whether estrogen is given alone or in combination with progestin.
- medical record: Your family history and personal medical history and your risk for cancer, heart disease, stroke, blood clots, liver disease and osteoporosis are important factors in determining whether hormone replacement therapy is appropriate for you. When deciding on menopausal hormone therapy, the individual and his or her physician should consider all of these risks.
How can we reduce the risks of hormone therapy?
1. Choose the best method according to the circumstances
Estrogen can be taken in the form of pills, gels, vaginal creams, suppositories or rings. If you only have menopausal vaginal symptoms, low-dose estrogen in a cream, pill, or vaginal ring is a better choice than an oral pill or skin patch.
۲. Minimize the amount of medication taken
One should use the least effective dose for the shortest time possible. If you are under 45, you need enough estrogen to protect against the long-term effects of estrogen deficiency. If the symptoms of menopause are persistent and disrupt a person’s life, your doctor may recommend long-term treatment.
3. Regular medical care
You should see your doctor regularly for screenings such as mammograms and pelvic exams to make sure the benefits of hormone therapy outweigh the risks.
4. Choose a healthy lifestyle
- Incorporate physical activity and exercise into your daily routine;
- healthy diet;
- Not smoking;
- Avoid alcohol;
- Stress management;
- Regular control of high cholesterol or high blood pressure.
Who should not use menopausal hormone therapy?
A person with the following conditions should avoid hormone therapy:
- blood clotting;
- Cancer (breast, uterus, ovary);
- Heart, liver or gallbladder disease;
- heart attack;
- Possibility of pregnancy;
- Unexplained vaginal bleeding.
What should we do if we can not do hormone therapy?
Menopausal hot flashes can also be controlled with healthy lifestyle approaches, for example:
- Keeping the body cool;
- Use less caffeinated beverages;
- Abstinence from alcohol;
- Practice slow breathing or other relaxation techniques.
There are several non-hormonal medications that may help relieve hot flashes.
For vaginal discomfort such as dryness or painful intercourse, a vaginal moisturizer or lubricant can be soothing.
After all, is menopausal hormone therapy good or bad?
Consult a doctor to determine if hormone therapy is a viable treatment option. A person’s health status determines whether hormone therapy is right for him or her.
Have you ever had hormone therapy? If you have any experience or comment on this, please share it with us and other users in the comments section.