Hormone therapy works extremely well to relieve common symptoms of menopause, including hot flashes, bone loss and vaginal dryness. But depending on your health situation and medical history, the risks of hormone therapy may outweigh the benefits.
To help you decide, here is the latest scientific information on hormone therapy, and what you should know before you see your doctor:
Nearly two decades ago, doctors stopped prescribing hormone replacement drugs after two large studies revealed some risks of long-term use, including an increased risk of heart disease, blood clots, stroke and breast cancer. Recently, however doctors have softened this “cold turkey” approach after a more recent study showed estrogen and cyclic monthly progesterone given to healthy women ages 42 to 59 proved both safe and helpful in improving symptoms of menopause, as well as mood, bone density and several markers of cardiovascular risk.
Still, hormone therapy does carry risks for women with certain health histories or conditions and so may not prove the best option for everyone. Women with a history of breast cancer, blood clots, heart disease or liver disease in particular should look into non-hormone medications. Luckily, alternative medical treatments have expanded over the last decade to address certain health concerns.
Though not as effective as hormone therapy, some drugs typically used for other health issues such as depression, anxiety and epilepsy reduce hot flashes in many women without the same risks of hormone therapy. One of these drugs, a selective serotonin reuptake inhibitor called Brisdelle®, is the first non-hormonal drug approved by the FDA specifically for hot flashes.
Sleep medications will not reduce hot flashes but may help you sleep through them.
Alternative options also exist for women with specific health needs or concerns such as:
In general, starting hormone therapy within 10 years of your last period is now considered safe for most women who are experiencing symptoms that interfere with their quality of life or sense of well-being, such as hot flashes. Your provider is your partner and together you will find the right option for you for this time of your life. After your last period, your provider may recommend alternative, non-hormonal treatment. And remember, once on a therapy, allow at least 12 weeks to determine its effectiveness. Contact your doctor immediately if you have any health changes or concerns. Even if the therapy works, your doctor will want to see you regularly – probably annually – to reevaluate. Typically, about half of women are able to decrease or go off hormones completely after three to five years without returning symptoms. The other half remain symptomatic and may choose to continue therapy.
If your emotions seem more out-of-whack than normal during menopause, you’re not alone – and understanding why can help.
