Menopause is a normal part of aging that describes the changes women go through before and after menstrual cycles. This ultimately marks the end of the reproductive period, in which the ability to have children is over.
The ceasing of menstruation is caused by the natural decline in women reproductive hormones. As women approach their late 30s, the ovaries start making less estrogen and progesterone. These female-dominant sex hormones regulate menstruation and ovulation.
Lower levels of these hormones lead to common symptoms of menopause, including mood swings, vaginal dryness, hot flashes, and night sweats. Menopause also increases the risk of heart disease and bone loss.
Menopause can likewise be the result of medical conditions and treatments. For instance, a hysterectomy is the removal of a female's uterus, which ends menstrual cycles. Radiation, chemotherapy, and certain medications can also induce menopause. A rarer condition, known as primary ovarian insufficiency, disrupts normal periods in women aged 40 or younger.
But because menopause is mostly considered a normal part of aging, there is no cure. Instead, a number of treatment options exist to lower negative side effects and enhance the quality of life.
Some women may use hormone replacement therapy (HRT), or simply known as hormone therapy (HT). While some women benefit from HRT, there are added risks of taking it. Find out whether or not menopausal hormone replacement therapy is right for you.
Menopause Hormone Therapy
Several types of hormone therapy exist. There are also different ways women can take them.
The North American Menopause Society (NAMS) the two basic types of hormone therapy. These include estrogen-only and estrogen plus progestogen therapies:
• Estrogen-only therapy (ET) is prescribed to women who have undergone a hysterectomy, a procedure that removes the uterus. Estrogen is the hormone that provides the most menopausal symptom relief.
• Estrogen plus progestogen therapy (EPT) is namely a combination of estrogen and progestogen. The progestogen is mostly added to ET to protect women with a uterus against uterine (endometrial) cancer from estrogen alone.
Hormone therapies can be taken in different ways, too. These include products that are used systemically or locally:
• Systemic products circulate throughout the bloodstream and to all parts of the body. They are available in many forms, including oral tablets, patches, gels, sprays, and injection. Systemic therapies can be used for hot flashes and night sweats, vaginal symptoms, and osteoporosis.
• Local, or nonsystemic, products affect only specific or localized areas of the body. For instance, vaginal estrogen creams are often used for vaginal symptoms such as dryness and itchiness. Local products are available as rings and tablets as well.
Risks and Benefits of Menopause Hormone Replacement
In theory, replacing lost hormones is logical. However, there are evidence-based benefits and risks of menopause hormone therapy women should consider.
Benefits of HRT
Also according to the North American Menopause Society, hundreds of clinical studies have provided evidence that hormone therapy helps many conditions. This includes estrogen therapies with or without progestogen.
Menopause hormone replacement proves to relieve hot flashes, vaginal dryness, night sweats, and bone loss. Such benefits can, in turn, improve sleep, sexual relations, and quality of life.
NAMS further suggests younger menopausal women, compared to older postmenopausal women, may benefit most from HRT.
Risks of HRT
On the flip side of the coin, the Food and Drug Administration warns serious health risks are tied to hormone therapies. These include:
• Blood clots
• Heart attacks
• Strokes
• Breast cancer
• Dementia
• Liver problems
• High blood pressure and triglyceride levels
• Severe allergic reactions
• Endometrial cancer, particularly specific to taking only estrogen replacement therapy
Noted, less serious yet common side effects include headaches, tender and painful breasts, vaginal spotting, hair loss, nausea, and vomiting.
What's more, researchers investigated the benefits and risks of long-term hormone therapy. But the study was stopped early when it was apparent the treatment was doing more harm than good. More specifically, hormone therapy with estrogen-progestin drugs was stopped after about five years. Hormone therapy with estrogen alone was stopped after almost seven years.
At this point in time, the research thus far suggests hormones should not be taken for a long period of time. So to lower the risks associated with hormone therapy use, health experts recommend taking the lowest effective dose. They further recommend using any sort of HT for a short duration, or often no more than 5 years.
Is Hormone Therapy Right For Me?
Ultimately, consult with a doctor regarding whether or not estrogen therapy or other hormone replacement is right for you. They will help take a number of factors into consideration, including age, a medical history, and preferences. After a thorough eval, they can outweigh the risks and benefits, as well as recommend a type and potential dosing needs.
Health professionals can likewise assist in strategizing alternative methods that may offer symptom relief without HRT use. For instance, adopting a healthy lifestyle can also alleviate symptoms of menopause and reduce the risks of health complications. Factors involve diet, exercise, stress management, and sleep hygiene.
• A balanced diet rich in fiber, lean protein, and healthy fat is recommended. The combination of these nutrients supports a healthy weight. A low-glycemic diet can improve hormone levels to subsequently stave against hot flashes, too.
• Exercise on a regular basis for a bounty of health benefits, including weight management and menopausal symptom relief. There are many ways to stay active during menopause, including walking the dog or with a loved one after dinner. Aim for 150 minutes of cardio and incorporate 2 to 3 strength training sessions each week.
• Menopausal effects on mental health may trigger depression and anxiety. This, in turn, exacerbates symptom risks such as mood swings. Manage stress with positive coping techniques, including exercise, yoga, and meditation.
• Getting a good night's rest may be a challenge, but it is important to support overall health during menopause. Achieve the National Sleep Foundation's recommendation of seven to nine hours by staying consistent with sleep and wake times. Maintain a cool room temperature to help induce natural sleep cycles and lower the risks of night sweats.
Ultimately, making lifestyle changes can be successful in managing menopause symptoms, with or without hormone therapy. Finding relief with more natural remedies also deters from the risks of taking hormone therapy.
