• Menopause
• Uniquely Female

Is Menopausal Hormone Therapy Right for You?

If your overall health is good but symptoms of menopause are interfering with your quality of life, you may find some relief with menopausal hormone therapy (MHT). Formerly called hormone replacement therapy, the use of hormones estrogen and progesterone (or its synthetic form progestin) is considered safe for healthy women in the first five years after menopause.

“We used to think that hormone therapy was the answer to many health issues women face as they age. Research has shown us that there’s a lot more at stake, and we weigh the positives versus the negatives as we decide when or if to prescribe hormone therapy,” says says Lifestages Centers for Women physician William Rettig, MD.

How It Works

The hormones may be taken alone or in combination, depending on a woman’s health history and whether she has had a hysterectomy.

Hormone therapy can be taken as a pill or injection, or absorbed into your body through a patch on the skin, creams or gels. Some women use an intrauterine device or vaginal ring, especially if the primary symptom is vaginal dryness.

Benefits

“MHT may help with moderate to severe menopausal symptoms,” says Dr. Rettig. “We usually recommend that you take the lowest possible dose for the shortest period of time.” Benefits include:

• Reducing hot flashes, night sweats, and related problems such as poor sleep and irritability
• Treating vaginal symptoms, such as dryness and discomfort, and related issues, such as pain during sex
• Slowing bone loss
• Possibly easing mood swings and mild depressive symptoms. If you have stronger signs of depression, talk with your doctor.

Risks

“We generally discourage long-term use of MHT, because it can increase the risk of blood clots, heart attack, stroke, breast cancer and gall bladder disease in some women,” Dr. Rettig says. In addition, possible side effects of MHT include:

• Vaginal bleeding
• Bloating
• Breast tenderness or swelling
• Headaches
• Mood changes
• Nausea

You also may experience symptoms when you stop taking MHT.

We weigh the positives versus the negatives as we decide when or if to prescribe hormone therapy.

Women who are pregnant or have any of the following issues should not take MHT:

• Problems with vaginal bleeding
• Certain kinds of cancers (such as breast and uterine cancer)
• History of stroke, heart attack or blood clots
• Liver disease
• Heart disease

Ongoing Research

The most comprehensive evidence about risks and benefits of MHT comes from two large clinical trials sponsored through 2004 by the National Institutes of Health as part of the Women’s Health Initiative. The studies ended a decade ago, but they continue to have a large impact on the uses of hormone therapy.

Research continues on the risks and benefits of MHT. For example, a recent study of MHT in patch form may not have the possible risk of stroke found with other forms of the therapy.

Source: Office on Women’s Health, U.S. Department of Health and Human Services; National Cancer Institute; National Heart, Lung and Blood Institute; William Rettig, MD, Lifestages Centers for Women

Lloyd W. Rettig, MD

Lifestages Centers for Women

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