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Can You Have Hrt After Menopause

Information For Your Doctor To Read Includes Ams Information Sheets:

Can Periods Restart After Menopause?

If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Doctor service on the AMS website.

NOTE: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to an individuals personal circumstances and should always be discussed with their own healthcare provider. This Information Sheet may contain copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members, other health professionals and their patients for clinical practice is permissible. Any other use of this information must be agreed to and approved by the Australasian Menopause Society.

What Can Be Done

Lifestyle factors

A healthy lifestyle can minimize the effects of the menopause, helping to keep the heart and bones strong. Many women feel that this is a good time to review the way they treat their body. Here are some tips to consider:

Complementary & alternative therapies

These have become a popular choice and many women use them, although limited scientific research has been done to support their effect or indeed their safety. They may sometimes help with troublesome symptoms, but they are unlikely to have a significant impact on bone strength, the heart or blood vessels.

Choosing a complementary or alternative therapy can be a challenge so many different ones exist. Acupuncture, aromatherapy, herbal treatments, homeopathy, hypnotherapy, yoga and reflexology have all been reported as being helpful in the menopause.

To find out more about available therapies, please consult the WHC fact sheet Complementary/alternative therapies for menopausal women.

Hormone Replacement Therapy

Hormone replacement therapy is the most effective and widely used treatment for menopausal symptoms. As its name suggests, it is simply a way of replacing the hormone oestrogen that is lost during the menopause.

Transitioning From Contraception To Hormone Therapy

Transitioning from contraception to hormone therapy may be challenging because oral contraceptives have higher dosages than typical hormone therapy regimens. Also, measuring follicle-stimulating hormone levels after stopping oral contraceptives can be inaccurate during perimenopause.26 One small study found that a rise in follicle-stimulating hormone level without a change in estradiol levels two weeks after stopping oral contraceptives is evidence that it is safe to transition to hormone therapy.26 Others suggest discontinuation of contraception when women are in their mid-50s because spontaneous conception is rare at this age.27

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Where Does Evidence About The Health Effects Of Mht Come From

The most comprehensive evidence about the health effects of MHT comes from two randomized clinical trials that were sponsored by the National Institutes of Health as part of the Womens Health Initiative :

  • The WHIEstrogen-plus-Progestin Study, in which women with a uterus were randomly assigned to receive either a hormone pill containing both estrogen and progestin or a placebo. The median duration of treatment was 5.6 years.
  • The WHI Estrogen-Alone Study, in which women without a uterus were randomly assigned to receive either a hormone pill containing estrogen alone or a placebo. The median duration of treatment was 7.2 years.

More than 27,000 healthy women who were 50 to 79 years of age at the time of enrollment took part in the WHI hormone therapy trials. The goals of these trials were to see if MHT prevents heart disease and bone fractures in postmenopausal women and to determine if MHT affects risks of breast cancer and, for women with a uterus, endometrial cancer. Both trials were stopped early , when it was determined that both types of therapy were associated with specific health risks, but long-term follow up of the participants continues to provide new information about the health effects of MHT.

How Long Can You Take Hormone Replacement Therapy

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    Not all women experience severe symptoms related to menopause, but for those who do, they can seriously affect their quality of life. If you have uncomfortable menopause symptoms, there are relief options. Hormone replacement therapy, or HRT, is a common treatment. Combination HRT, medicine containing both the hormones estrogen and progesterone, is the most common. But can youand should youkeep taking HRT for years? Or does there come a time when you need to stop taking them?

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    Why Does Menopause Happen

    Natural menopause menopause that happens in your early 50s and is not caused by surgery or another medical condition is a normal part of aging. Menopause is defined as a complete year without menstrual bleeding, in the absence of any surgery or medical condition that may cause bleeding to artificially stop As you age, the reproductive cycle begins to slow down and prepares to stop. This cycle has been continuously functioning since puberty. As menopause nears, the ovaries make less of a hormone called estrogen. When this decrease occurs, your menstrual cycle starts to change. It can become irregular and then stop. Physical changes can also happen as your body adapts to different levels of hormones. The symptoms you experience during each stage of menopause are all part of your bodys adjustment to these changes.

    What Can You Do About Your Symptoms

    There are two approaches to treat symptoms. They are medical and behavioral.

    • HRT is the best treatment for hot flashes
    • Anti-depressants known as selective-serotonin reuptake inhibitors are another option if you dont want to take HRT
    • Serotonin-norepinephrine reuptake inhibitors and gabapentin treat hot flashes

    If HRT is not right for you, there are alternative treatments you can try. These include yoga, mindfulness meditations, hypnosis, or exercise and weight loss. Talking to a therapist trained in cognitive behavioral therapy is another option.

    Keep in mind that everyone is different. Hang in there and dont get frustrated if the first treatment doesnt help. You may have to experiment a bit to find the right treatment for you. It may take a combination of HRT and alternative therapies to get relief from symptoms.

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    Is Hrt The Same As Birth Control

    No. Although women who take birth control pills are also taking estrogen and progestin, the effect is not the same. Women who take birth control pills have not been through menopause and need higher levels of hormones to prevent ovulation. HRT is not a high enough strength to stop ovulation.

    After menopause, estrogen levels are low and HRT is used at a low dose to restore hormone levels to a more normal level.

    Ovarian Cysts After Menopause

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    Ovarian cysts are fluid-filled sacs within the ovaries, which occur during ovulation. These cysts can be painful and bothersome, causing bloating and dull aches. Because they typically occur during ovulation, postmenopausal women may be surprised to find that they can still get ovarian cysts. As long as a woman has ovaries, she is still susceptible to developing ovarian cysts. However, most ovarian cysts are harmless and will go away without any treatments.

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    Are There Alternatives For Women Who Choose Not To Take Menopausal Hormone Therapy

    Women who are concerned about the changes that occur naturally with the decline in hormone production that occurs during menopause can make changes in their lifestyle and diet to reduce the risk of certain health effects. For example, eating foods that are rich in calcium and vitamin D or taking dietary supplements containing these nutrients may help to prevent osteoporosis. FDA-approved drugs such as alendronate , raloxifene , and risedronate have been shown in randomized trials to prevent bone loss.

    Medications approved by the FDA for treating depression and seizures may help to relieve menopausal symptoms such as hot flashes . Drugs that have been shown in randomized clinical trials to be effective in treating hot flashes include venlafaxine , desvenlafaxine , paroxetine , fluoxetine , citalopram , gabapentin , and pregabalin .

    Symptoms Of Perimenopause Vs Pcos

    You can continue to have symptoms of PCOS when you reach perimenopause and menopause. Perimenopause is the period before menopause thats often accompanied by symptoms such as hot flashes and irregular periods. During perimenopause, your hormone levels begin to change in preparation for menopause. Perimenopause can last for several years. Youre considered to be in menopause when you havent had a period for 12 months.

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    Perimenopause generally starts in your 40s or 50s. The average age of menopause is 51. Women with PCOS tend to reach menopause about two years later than women without PCOS.

    PCOS doesnt go away with menopause, so you can continue to have symptoms. Some symptoms of PCOS are similar to those of perimenopause. That can make it difficult for women to be newly diagnosed with PCOS during perimenopause.

    Symptoms of the two conditions include:

    Symptom

    Techniques for managing PCOS symptoms can also help manage some symptoms of perimenopause.

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    Treatment Options For Excessive Estrogen

    As with low estrogen, youve got a trio of options if levels of your female hormone are too high.

    • Medication: If you start experiencing high estrogen when youre on HRT, your doctor might well adjust your plan. This simple change can help restore balance.
    • Surgery: If youre unfortunate enough to have a cancer sensitive to estrogen, your doctor might recommend removing your ovaries in a procedure called oophorectomy.
    • Dietary Changes: Eating a diet rich in fiber and low in fat can help to naturally reduce elevated estrogen levels.

    Vergo is an interactive program that gives women the tools to understand their Menopause.

    • The Vergo iOS symptom tracker
    • The Vergo QuikTrak symptom tracker
    • Vergos Interactive Education Program, Journey Without a Roadmap: Understanding Menopause
    • Curated guides to the biggest questions and hottest topics around menopause symptoms and treatment options
    • Must-have information on male menopause: Theres an Andropause?
    • Terminology Cheat Sheets

    Should You Use Hormone Therapy During Menopause

    Hormone Replacement Therapy (HRT)

    When a woman begins having menopause symptoms like hot flashes, irregular periods or mood changes, she will probably wonder at some point whether she should take some type of menopause hormone therapy . Sometimes called hormone replacement therapy, or HRT, it usually refers to a combination of the female hormones estrogen and/or progesterone.

    Research is beginning to show what the risks and benefits of menopause hormone therapy are, but there is still a lot to learn about the effects of estrogen and progesterone on our bodies and our health. While it is a very effective treatment for many menopause symptoms, hormone therapy can increase the chances of other conditions, and the decision to use it is a balancing act of determining whether the pros outweigh the cons.

    The Womens Health Initiative study is the largest study done on menopausal women and focused on heart disease, bone fractures, and breast and colorectal cancers. One of the preventive strategies studied was the effect of hormone therapy on these conditions.

    The current recommendation for menopause hormone therapy suggests if hormone therapy is used to treat menopausal symptoms, it should be used in the smallest doses that are effective, for the shortest time necessary.

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    Benefits Of Taking Estrogen After Menopause

    • Post author Scientific review: Dr Heben’s Team

    In this article, I will explain the benefits of taking estrogen after menopause. Menopause happens in middle-aged women . Menopause is a condition where menstrual cycle stops, or the end of reproductive period. This is a natural condition, and all women will experience this. But the menopause symptoms give anxiety in women, since the stopping of menstrual cycle means the stopping of reproductive hormone production, such as estrogen and progesteron.

    Estrogen is a steroid hormone, produced by theca follicle cells in ovaries. Estrogen functions are: promotes secondary sexual signs in women, promotes proliferation of endometrium cells, influences electrolytes balance, and improves protein anabolism with growth hormones, as in growth of reproductive organs such as the womb and vagina.

    Pre-menopause Symptoms

    When a woman reach pre-menopause period, her estrogen production is much decreased. The symptoms are:

    • irregular menstruation
    • reduced bone density, which will lead to osteoporosis and bone fractures
    • increased risk of atherosclerosis and cardiovascular disease

    1. Prevents Dryness in Vagina

    Vaginal dryness is caused by lack of estrogen. This makes difficulties and pain during sexual intercourse, which can lead to physical and psychological trauma . Taking estrogen after menopause can maintain vaginal lubrication and elasticity.

    2. Increases Libido

    3. Prevents Pre-menopause Syndrome

    6. Prevents Atherosclerosis

    Can Menopause Cause Ovarian Cysts

    Perimenopause and menopause can cause ovarian cysts to occur because of the major fluctuations in hormone levels. Most times, ovarian cysts resolve on their own in a few weeks or months. However, once a woman ceases to have her periods for 12 months, ovarian cysts are less frequent but can still develop. After menopause, ovarian cysts usually occur for one of two reasons:

    • Non-cancerous growths
    • Fluid collection in the ovaries

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    Hrt After Premature Early And Surgical Menopause

    While most women experience natural menopausearound the age of 50, some women reach menopause much earlier or after surgery.In these cases, HRT should typically be started immediately.

    Menopause that happens before the age of 40 is known as premature menopause, while between 40 and 45 it is known as early menopause. Women who experience premature or early menopause can have the same symptoms as women who experience typical menopause, but may also be at greater risk for psychological distress and a number of serious physiological health conditions. Meanwhile, women who undergo oophorectomysurgical removal of one or both ovariesprior to natural menopause can experience even more severe symptoms due to the extreme and sudden drop in hormones as well as significant long-term health risks. For all women who experience premature, early, or surgical menopause these risks include cardiovascular disease, osteoporosis, neurological disease, mood disorders, and premature death.

    Due to these risks, it is typically recommended that women who experience premature, early, and surgical menopause start hormone replacement therapy as soon as possible. As the American Society For Reproductive Medicine, mincing no words, said of bilateral oophorectomy patients:

    In these cases, there is little doubt that HRTis the right choice and should be initiated immediately.

    Weighing The Hormone Replacement Therapy Pros And Cons

    Menopause after a Hysterectomy

    When it comes to getting HRT after surgical menopause, deciding what to do isnt easy. The contradictory headlines in the media in recent years havent helped. Its easy for women to feel like they are making the wrong choice, no matter what they do.

    When youre deciding, you have to consider a lot of different factors, including your age, your family history, and your habits. Just take it slowly and dont allow yourself to be rushed into a decision youre not ready to make. Check the latest research into HRT. Remember that both the potential long-term benefits and risks of hormone therapy are really quite small for any individual person.

    Finally, dont discount your gut feelings. The decision to get hormone therapy after surgical menopause is personal. The right answer depends as much on your preferences as it does on the facts in your medical chart.

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    Stroke And Heart Attacks

    The latest analysis from Women’s Health Concern regarding the risk of heart disease and stroke for women taking HRT states that:

    • the risk of stroke is increased in women who smoke and are overweight
    • women starting HRT and aged below 60 are not at an increased risk of stroke
    • HRT is not recommended for women with a history of stroke or deep vein thrombosis

    Speak to your GP if you are taking HRT and are worried about the risk of stroke or heart disease.

    Who Can Take Hrt

    Most women can have HRT if they’re having symptoms associated with the menopause.

    But HRT may not be suitable if you:

    • are pregnant it’s still possible to get pregnant while taking HRT, so you should use contraception until 2 years after your last period if you’re under 50, or for 1 year after the age of 50

    In these circumstances, alternatives to HRT may be recommended instead.

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    How Are Ovarian Cysts After Menopause Diagnosed

    A healthcare provider will try to rule out other conditions that may have similar signs and symptoms, such as appendicitis or pelvic inflammatory disease. To diagnose ovarian cysts, most healthcare providers will ask you questions first and perform a pelvic exam. In particular, they will inquire about your family history regarding ovarian cysts, ovarian cancer, and breast cancer.

    If your symptoms and exam indicate a possible ovarian cyst, your healthcare provider will order imaging tests to evaluate the size, shape, and location. The imaging test is usually an ultrasound performed either transvaginally or abdominally. An ultrasound will also indicate whether the ovarian cyst is fluid-filled or solid.

    If your symptoms and physical exam point toward an ovarian cyst, the next step may be an imaging test. Ultrasound can help reveal the size, shape, and exact location of a mass. It can also show whether the cyst appears to be filled with fluid or solid . A complex cyst may require further testing because it may potentially be cancerous. A blood test for the CA-125 cancer antigen can identify whether a cyst is cancerous or not. A higher than normal level of CA-125 in a postmenopausal woman with an ovarian cyst may indicate possible ovarian cancer.

    What Questions Remain In This Area Of Research

    Menopause facts vs fiction you need to know at any age

    The WHI trials were landmark studies that have transformed our understanding of the health effects of MHT. Its important to note that women who were enrolled in the WHI trials were, on average, 63 years old, although about 5,000 of them were under age 60, so the results of the study may also apply to younger women. In addition, the WHI trials tested single-dose strengths of one estrogen-only medication and one estrogen-plus-progestin medication .

    Follow-up studies have expanded and refined the original findings of these two trials. But many questions remain to be answered:

    • Are different forms of hormones, lower doses, different hormones, or different methods of administration safer or more effective than those tested in the WHI trials?
    • Are the risks and benefits of MHT different for younger women than for those studied in the WHI trials?
    • Is there an optimal age at which to initiate MHT or an optimal duration of therapy that maximizes benefits and minimizes risks?

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