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From hot flashes and mental fog to joint pain and insomnia.
There are many symptoms that accompany menopause and the transition to this stage of a woman’s reproductive life.
But for women who suffer from some of them and feel that they are causing a deterioration in their quality of life, there is the option of hormone replacement therapy (also called simply hormone therapy or hormone replacement therapy).
If you are considering this alternative, here is a guide to some basic questions to help you understand what factors to consider or consider.
What is hormone replacement therapy?
As menopause approaches, estrogen levels fluctuate and decline in women.
Estrogens have many functions: they help regulate menstrual cycles, contribute to strong bones and influence the temperature of our skin.
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Hot flashes are perhaps one of the most well-known symptoms of menopause.
When estrogen levels become unstable, various symptoms such as hot flashes, night sweats, anxiety, and joint pain may occur.
Hormone therapy increases estrogen levels in a woman’s body and can help relieve these symptoms.
Women who take it usually don’t take it forever, just to ease the transition into menopause, and many say it has made a big difference to their well-being.
Hormone replacement therapy may also have other benefits, such as preventing bone loss and fractures. For women under 60, it may also offer some protection against heart disease.
You may have heard of other potential benefits, such as protecting brain health and improving skin and hair, but so far the evidence for these benefits is limited.
How is-il administered?
Treatment comes in many shapes and sizes, from pills and patches to gels and rings.
The main ingredient is estrogen, but one of the most common forms is combination therapy, in which estrogen is given along with a synthetic version of the hormone progesterone.
Adding progesterone helps protect the uterine lining, as estrogen alone can sometimes increase the risk of uterine cancer.
The best type of therapy varies from person to person and depends on symptoms and lifestyle. In general, start with the lowest dose possible.
Which therapy is best for me?
Most hormonal therapies affect the whole body. But some – like Gina 10, available over the counter in the UK – are used vaginally only, to relieve symptoms in that part of the body.
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In the UK, Gina 10 is now available in pharmacies without the need to see a doctor.
This minimizes the amount of estrogen absorbed by other parts of the body, but means that these treatments do not relieve other symptoms such as hot flashes.
How long does it take for the treatment to take effect?
It may take up to three months before the full effects are felt, and the dose and type of hormone therapy may need to be adjusted or changed.
Most experts recommend starting hormone replacement therapy at the first signs of menopause.
The evidence is mixed and limited when it comes to starting after age 60, although some women experience relief from persistent symptoms.
There is no limit to the duration of the intake. Some support the idea of continuing treatment for many years, but the UK Medicines and Health Products Regulatory Agency recommends using it at the lowest dose and for the shortest duration possible.
What are the risks ?
Although this therapy has had bad press in the past, its benefits are thought to outweigh its risks.
Two studies published in the early 2000s suggested it had more harmful effects than beneficial. This received wide publicity and its use was curtailed.
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According to the British Menopause Society, the risk of cancer is lower than drinking more than two units of alcohol a day or being overweight.
Some remain cautious, despite growing evidence that the treatment can be helpful.
Certain types of therapy have been associated with a slightly increased risk of cancer. The combination, for example, may be associated with a small increased risk of breast cancer.
But the British Menopause Society estimates that this risk is less than that of drinking more than two units of alcohol a day or being overweight. And the risk gradually decreases after stopping the drug.
There is a small risk of developing a blood clot while taking this medicine. However, it also depends on other factors, such as smoking, weight and age.
The risk is lower if you use skin patches or gel instead of tablets.
The risk of a blood clot is much lower than that from taking birth control pills or becoming pregnant.
What are the side effects ?
Many side effects appear within three months of starting treatment. They can understand
It is common to gain weight as you approach menopause, but there is no evidence that hormone therapy is the cause.
Who should not use this treatment ?
It may not be suitable in these cases:
– if you have had breast, uterine or ovarian cancer
– untreated high blood pressure
– if you have had blood clots
What else can I do?
Regular exercise can help you sleep better, reduce hot flashes and improve your mood.
Eating a healthy diet, reducing the intake of coffee, alcohol, spicy foods, and quitting smoking can also help alleviate hot flashes.
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Regular exercise helps to cope with the symptoms of menopause.
Physical exercises, hiking, brisk walking or playing tennis also contribute to strong bones.
Other drugs like Tibolone, which works by mimicking the activity of estrogen and progesterone, or certain antidepressants can help. But they can also have side effects.
You may have heard of bioidentical hormones. The UK National Health Service, for example, does not recommend them because they are unregulated and their safety is unclear.
