Get answers to your menopause and sexual dysfunction questions.
Treatment with hormones may be helpful if you have severe symptoms such as hot flashes, night sweats, mood issues, or vaginal dryness.
Discuss the decision to take hormones thoroughly with your doctor, weighing your risks against any possible benefits. Learn about the many options currently available to you that do not involve taking hormones. Every woman is different. Your doctor should be aware of your entire medical history before prescribing hormone therapy (HT).
If you have a uterus and decide to take estrogen, you must also take progesterone to prevent endometrial cancer (cancer of the lining of the uterus). If you do not have a uterus, progesterone is not necessary.
Several major studies have questioned the health benefits and risks of hormone replacement therapy, including the risk of developing breast cancer, heart attacks, strokes, and blood clots.
Current guidelines support the use of HT for the treatment of hot flashes. Specific recommendations:
To reduce the risks of estrogen therapy and still gain the benefits of the treatment, your doctor may recommend:
See also: Hormone therapy for more information about taking hormone therapy.
ALTERNATIVES TO HT
There are some medications available to help with mood swings, hot flashes, and other symptoms. These include low doses of antidepressants such as paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), and fluoxetine (Prozac), or clonidine, which is normally used to control high blood pressure. Gabapentin is also effective for reducing hot flashes.
The good news is that you can take many steps to reduce your symptoms without taking hormones:
Postmenopausal bleeding may occur. This bleeding is often nothing to worry about. However, your health care provider should always check any postmenopausal bleeding, because it may be an early sign of other problems, including cancer.
Decreased estrogen levels are also associated with the following long-term effects:
Call your health care provider if:
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice. ACOG Committee Opinion No. 420, November 2008: hormone therapy and heart disease. Obstet Gynecol. 2008 Nov;112(5):1189-92.
Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010 Jan-Feb;17(1):25-54; quiz 55-6.
North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010 Mar;17(2):242-55.
Col NF, Fairfield KM, Ewan-Whyte C, Miller H. In the clinic. Menopause. Ann Intern Med. 2009 Apr 7;150(7):ITC4-1-15.
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