Hormone therapy for menopause can relieve problematic symptoms, according to the North American Menopause Society, the American Society for Reproductive Medicine, and The Endocrine Society. With that being said, those organizations believe that women should have all the facts about hormone therapy for menopause before going into it.
The three major organizations we mentioned all agree that hormone therapy helps in the following ways:
- When it comes to reducing symptoms of menopause, hormone therapy is the most effective known treatment.
- If vaginal dryness is the only symptom, low doses of vaginal estrogen is the recommended treatment.
- The symptom of hot flashes requires a higher-than-usual dose of estrogen therapy because it will have an effect on the entire body.
- A progesterone treatment, in addition to estrogen, is recommended to fight cancer of the uterus. The recommended duration for this treatment is five years or less.
- In the event that the uterus has been removed, estrogen can be taken alone.
Risks of Hormone Therapy for Menopause
Depending on age, lifestyle, and personal factors, hormone therapy for menopause may not be right for you. Let these facts help determine whether or not you are a good candidate for the treatment.
- There is an increased risk of blood clots in the legs and lungs when undergoing hormone therapy. Although the risk is minimal in the 50-59 age group. The risk is more likely when taking estrogen orally. Transdermal estrogen is not associated with this risk.
- Five or more years of continuous estrogen/progestogen therapy may result in an increased risk of breast cancer. When hormone therapy is stopped, the risk goes down. The Women’s Health Initiative trial determined that using only estrogen for an average of 7 years did not increase the risk of breast cancer. These studies used synthetic progestin. Using natural bioidentical progesterone has not been associated with this risk. Larger studies are needed to be more definitive.
Low-dose estrogen pills approved by the Food and Drug Administration (FDA) are linked to reduced risks of blood clots and strokes than standard doses of estrogen pills. Another published study stated bioidentical hormones with estrogen given topically and progesterone given orally are more beneficial hormone replacement options. HRT optimization, using transdermal estradiol plus micronized progesterone, a safer HRT. Giving estrogen topically decreases the risk of clots, embolism, and stroke and gallbladder disease. Bioidentical progesterone had positive effects on decreasing blood pressure, clots and embolism and even breast cancer. The list of studies goes on and on. The review article “Could transdermal estradiol + progesterone be a safer postmenopausal HRT? A review, “came up with different conclusions from the Women’s Health Initiative. They challenged the premise of that study and looked at reviewed other studies and their conclusion was that the risk of clots and liver and gallbladder disease with topical estrogen was negligible and natural progesterone has a favorable effect on the blood vessels and brain and may even confer less or no risk of breast cancer.
Many FDA-approved options exist for hormone therapy using hormones that are biochemically identical to one’s own. It is thought that using bioidentical hormone therapy, when possible, leads to fewer risks.
For healthy women aged 60 years or younger, hormone therapy for menopause is an acceptable option when being bothered by moderate to severe menopause symptoms. However, with most medical treatments, in order to know for sure if it is a good option some individual assessment is required.
When considering hormone therapy, the woman’s quality of life as well as personal risk factors need to be taken into consideration. Personal risk factors could include things such as age, time since menopause, and her risk of blood clots, heart disease, stroke, and breast cancer.
Experts agree hormone therapy plays an important role in being able to manage the symptoms of menopause. Further research will be conducted to learn more information about hormone therapy as it relates to menopause. For more information see our page on bioidentical hormone therapy.
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