Hormone Therapy For Menopause Symptoms

Overview

Hormone therapy (HT) is a treatment for menopausal symptoms, with considerations including age, family and personal medical history, and symptom severity. As women transition into menopause, their ovaries produce lower levels of estrogen and progesterone, leading to discomfort. Common symptoms include hot flashes, night sweats, vaginal dryness, urinary urgency, insomnia, mood swings, and dryness of the skin, eyes, or mouth. HT aims to alleviate these symptoms by boosting hormone levels, but its suitability should be discussed with a healthcare provider due to associated health benefits and risks.

Types

Hormone treatment (HT) comes in two types:

• Estrogen Therapy: Healthcare providers most frequently recommend taking a daily pill or patch with a low amount of estrogen. Additionally, prescriptions for estrogen might be written for a cream, gel, spray, or vaginal ring. In order to treat menopausal symptoms and/or avoid osteoporosis, the patient should take the lowest dosage of estrogen prescribed.
• Estrogen Progesterone/Progestin Hormone Therapy (EPT): This type of hormone therapy, often known as combination therapy, combines estrogen and progesterone (or progestin, a synthetic progesterone) dosages.

Reasons for undergoing the procedure

Hormone therapy (HT) is commonly prescribed to alleviate menopausal symptoms, which may include hot flashes, vaginal dryness leading to painful intercourse, night sweats, and dry, itchy skin. Additionally, HT offers several health advantages such as reducing the risk of osteoporosis and bone fractures, enhancing mood and mental well-being for certain individuals, decreasing tooth loss, lowering the risk of colon cancer and diabetes, providing modest relief from joint pains, and potentially reducing mortality rates for women in their 50s who undergo hormone therapy.

While hormone therapy (HT) offers relief for many women experiencing menopause, it’s essential to recognize that like any medication, both prescription and over-the-counter, it carries potential risks. These risks include:

• Increased susceptibility to gallbladder or gallstone issues.
• Elevated risk of endometrial cancer (for individuals with a uterus who are not concurrently taking a progestin alongside estrogen).
• Elevated risk of breast cancer with prolonged usage.
• Heightened likelihood of blood clots and stroke.
• Elevated risk of dementia if HT is initiated after midlife. However, starting HT during midlife is associated with a reduced risk of Alzheimer’s disease and dementia.

Risk

Research on hormone therapy (HT) and cardiovascular health in women continues, presenting conflicting findings. Some studies suggest potential benefits for those starting HT within 10 years of menopause, while others highlight risks, especially if initiated later. The American Heart Association advises against using HT solely for heart disease prevention, citing increased breast cancer risk with combined therapy, with a slight increase in breast cancer risk, while estrogen-only therapy post-hysterectomy may show a non-significant reduction in risk. Individuals with a breast cancer diagnosis should avoid systemic hormone therapy.

Despite its efficacy in managing menopausal symptoms, HT poses risks. These include a higher risk of endometrial cancer for those with an intact uterus not taking progestin alongside estrogen, as well as increased risks of blood clots, stroke, and gallbladder issues. Notably, starting HT after midlife may heighten dementia risk, while midlife initiation is linked to reduced Alzheimer’s disease and dementia risks. Long-term HT use is associated with an increased risk of breast cancer.

Procedure

The following list provides the names of some, but not all, postmenopausal hormones.

• Estrogen
  • Pills
  • Creams
  • Vaginal ring
  • Vaginal tablet
  • Patch
  • Spray
• Combination EPT
  • Pills
  • Patch
• Vaginal dehydroepiandrosterone (DHEA)
  • Vaginal insert

Outcome

There is typically no set duration for hormone therapy (HT). It’s advisable to use the lowest effective dose of HT, with regular monitoring by your healthcare provider to review your treatment annually. If you encounter a new medical condition during HT usage, consult your provider to determine whether it’s still appropriate to continue with the therapy.