Diagnosis & Tests For Hormone Replacement Therapy
If you are age 45 and above, your doctor may not test you for signs and symptoms of menopause. Once symptoms occur, your doctor may examine you, take a personal and medical history, and work out lifestyle factors that improve your symptoms.
If you are under age 45, your doctor may perform blood tests to determine your hormone levels. They may also perform ultrasounds and physical exams to find the cause of your hormone deficiency.
For How Long Can I Take Hrt
You are likely to have heard that you can only take HRT for 5 years. But this is a figure that seems to have been randomly allocated and of course you could then be experiencing all the symptoms at 55 that you stopped at 50 by using HRRT at that time!
So, the current advice is now to take it for as long as you feel well. The risks of doing this are extremely low compared to the major benefits which are that:
- If you are suffering from symptoms these tend to go away very quickly so you feel like your old self
- Longer term it reduces your risk of heart disease by 50% – and you are 7 times more likely to die of heart disease than from breast cancer
- It protects your bones 1 in 2 women over 50 will experience a fracture and the older you get the more likely you are to die of a complication from this
- It reduces your risk of bowel cancer by 30%
- Theres almost certainly a reduction in the risk of contracting Alzheimers or Dementia
I am confident that the risks outweigh the benefits as it has been shown that women who take HRT have a lower risk of death from all causes than women who do not take HRT.
As you get older, we might reduce the dosage or the way in which it is administered but, generally speaking, we advise that you stay on it for at least 7 years and then have a review.
Types Of Studies Of Hormone Therapy And Cancer Risk
Different types of studies can be used to look at cancer risk from menopausal hormone therapy .
Randomized controlled trials: In this kind of study, a group of patients get the drug being studied , and another group gets a placebo . Results from this kind of study are powerful because which group a patient is in is based on chance. This helps assure that the groups are similar in all ways, such as risk for cancer, except for the drug thats being studied. This is the best way to see the effects of a drug. These types of studies can also be double-blinded, which means neither the people in the study nor their doctors know which group they are in. This lowers the chance that thoughts or opinions about treatment could affect the study results. Unfortunately, these kinds of studies are costly, which limits the number of people in the study, how long the study can continue, and the number of studies done.
A major drawback of observational studies is that the people getting the treatment being studied may have different cancer risk factors than the people who arent. Plus, the treatment can differ between the people being studied. This makes it less clear that the differences seen are only due to the drug being studied and not other factors.
When observational studies and randomized controlled trials have different results, most experts give more weight to the results of the randomized controlled trial.
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- Menopausal symptoms can be managed with education, lifestyle changes, support and hormone replacement therapy , also known as menopausal hormone therapy .
- In the early postmenopausal years, HRT is an effective therapy for menopausal symptoms. In most women with moderate to severe symptoms, the benefits outweigh the small increases in risk.
- The long-term use of HRT has some benefits, but also has some risks.
- The current role of HRT is for menopausal symptom relief, at the lowest effective dose and for the shortest duration required for the control of bothersome menopausal symptoms.
- The decision to use HRT, and for how long it should be used, must be based on individual assessment and needs.
Hot Flashes During Perimenopause
Most women don’t expect to have hot flashes until , so it can be a big surprise when they show up earlier, during perimenopause. Hot flashes sometimes called hot flushes and given the scientific name of vasomotor symptoms are the most commonly reported symptom of perimenopause. They’re also a regular feature of sudden menopause due to surgery or treatment with certain medications, such as chemotherapy drugs.
Hot flashes tend to come on rapidly and can last from one to five minutes. They range in severity from a fleeting sense of warmth to a feeling of being consumed by fire “from the inside out.” A major hot flash can induce facial and upper-body flushing, sweating, chills, and sometimes confusion. Having one of these at an inconvenient time can be quite disconcerting. Hot flash frequency varies widely. Some women have a few over the course of a week others may experience 10 or more in the daytime, plus some at night.
Most American women have hot flashes around the time of menopause, but studies of other cultures suggest this experience is not universal. Far fewer Japanese, Korean, and Southeast Asian women report having hot flashes. In Mexico’s Yucatan peninsula, women appear not to have any at all. These differences may reflect cultural variations in perceptions, semantics, and lifestyle factors, such as diet.
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What Are The Types Of Hormone Therapy
There are two main types of hormone therapy :
- Estrogen Therapy: Estrogen is taken alone. Doctors most often prescribe a low dose of estrogen to be taken as a pill or patch every day. Estrogen may also be prescribed as a cream, vaginal ring, gel or spray. You should take the lowest dose of estrogen needed to relieve menopause symptoms and/or to prevent osteoporosis.
- Estrogen Progesterone/Progestin Hormone Therapy : Also called combination therapy, this form of HT combines doses of estrogen and progesterone .
Cardiovascular Disease And Hrt
Women over 60 have a small increased risk of developing heart disease or stroke on combined oral HRT. Although the increase in risk is small, it needs to be considered when starting HRT, as the risk occurs early in treatment and persists with time.
Oestrogen used on its own increases the risk of stroke further if taken in tablet form, but not if using a skin patch. Similarly, tibolone increases the risk of stroke in women from their mid-60s.
Women who commence HRT around the typical time of menopause have lower risks of cardiovascular disease than women aged 60 or more.
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Who Can Use It
You can begin hormone replacement therapy as soon as you start experiencing menopausal symptoms.
The average age for women to experience the menopause in the UK is 51. However, some women have the menopause when they are in their 30s, 40s or 60s. There is no way of predicting exactly when the menopause will happen.
Some women have menopausal symptoms, such as hot flushes and vaginal dryness, in the 3 to 4 years before the menopause. This is known as the peri-menopause.
The peri-menopause occurs because levels of the female sex hormones, oestrogen and progesterone, fall when the number of remaining eggs drops below a certain level. This means you may experience menopausal symptoms even when you are still having periods.
In most cases, HRT can be used without taking a test to confirm you are starting the menopause. A test for the menopause is usually only necessary if you are under 40 years old or have unusual bleeding patterns during your period.
Who Shouldn’t Take Hormone Therapy
Hormone therapy is not usually recommended if you:
- Have or had breast cancer or endometrial cancer.
- Have abnormal vaginal bleeding.
Less common side effects of hormone therapy include:
- Fluid retention.
- Skin discoloration .
- Increased breast density making mammogram interpretation more difficult.
- Skin irritation under estrogen patch.
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What Are The Risks Of Mrt
When assessing the risks associated with MRT, remember that not all women have the same risk of these effects.
- Risks vary based on how old you are, when you start MRT and how long you take it for.
- Short-term use in early menopause has fewer risks than when it is started later in menopause.
- Risks generally increase as you get older.
- The risks of developing blood clots while taking MRT is much higher for women who are obese, have severe varicose veins or have a close family member who has had deep vein thrombosis or pulmonary embolism.
|Women who take MRT have slightly higher rates of the following conditions:|
For most women with moderate to severe symptoms, the benefits appear to outweigh the risks for those who are less than 10 years out from menopause or aged less than 60.
How To Control Menopause Hormone Levels
In fact, there is no one magic pill that can control hormone levels in menopause. But, there is an efficient therapy that can eliminate most of these symptoms. Have you ever noticed that West women are more active at this age? They take hormone replacement therapy and live longer. The designated preparations contain estrogens and progesterone needed in our body in a small amount. So, hormone levels after menopause or during it will be stable, and women can feel comfortable.
Keep in mind, there is one myth around this therapy aimed to affect hormone levels in menopause, that a woman will get fat from these hormones. It is completely untrue. A woman is gaining weight only because of a lack of estrogens that once were normal. Without them, fat accumulates.
Accordingly, hormone therapy will help you to avoid such things, and menopause and hormone levels care will keep you fit. Moreover, doctors are trained enough to determine the right strength and dosages of a hormonal treatment so that a woman does not even notice any ailments or negative consequences. If you have a chance to undergo it, use this option because as of now it is the most efficient solution invented by dedicated experts for moderating and controlling hormone levels in menopause.
How We Can Help
Medical providers have changed their views about HRT. There is a great deal of information to discover. The studies already done dont address all of the issues that women face.
Women have many issues to address before deciding to use HRT. These include risks, age, preferences, options available, and the cost of the treatment.
Questions for your doctor include:
Once you evaluate and understanding your situation, you can make an educated decision. Make sure to talk to your doctor and ask as many questions as you need. Re-evaluation of the treatment options may change as new therapies become available and as you age.
Now is the time to treat yourself and learn what your body needs. Maintain a healthy lifestyle through healthy foods, exercise, and good sleep. Do what feels good for your body. Enjoy feeling comfortable within your body when your menopausal symptoms disappear with HRT.
If your goal is to reduce your risk of future health issues or maintain your quality of life, there are a variety of treatments to choose from. Have a discussion with your doctor and weigh all your options.
Information about HRT is consistently evolving. As new information is discovered through research, your options increase.
Check out many of the issues women face when going through menopause.
What Are The Risks Of Taking Hormone Therapy
While hormone therapy helps many women get through menopause, the treatment is not risk-free. Known health risks include:
- An increased risk of endometrial cancer .
- Increased risk of blood clots and stroke.
- Increased chance of gallbladder/gallstone problems.
- Increased risk of dementia if hormone therapy is started after midlife. HT started during midlife is associated with a reduced risk of Alzheimers disease and dementia.
- Increased risk of breast cancer with long-term use.
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Your Cardiovascular Disease Risk Will Reduce
HRT gives greater protection for heart health. Heart disease and stroke are the #1 killer of women in Ireland & worldwide.
1 in 2 Irish women will die from cardiovascular disease.
Irish women are 7 times more likely to die from cardiovascular disease than breast cancer.
5,000 Irish women die from cardiovascular disease each year.
Thats 5,000 families without a mother, sister, aunt, gran a loved one!
Thats an average of one woman every 2 hours.
If you are under 60 years old, HRT does not increase your risk of heart disease. In addition, it does not affect your risk of dying from heart disease.
There is some evidence that taking HRT, especially HRT with oestrogen alone, reduces your risk of developing cardiovascular disease . The benefits are greatest in those women who start HRT within ten years of their menopause.
HRT can also lower your cholesterol levels which is beneficial for your heart and body.
Check If You Can Have Hrt
Most women can have HRT if they have symptoms related to the menopause.
But your GP may recommend alternatives to HRT if you:
- have had breast cancer, ovarian cancer or womb cancer
It’s still possible to get pregnant while on HRT.
HRT may not be safe for you or your baby.
If you do not want to get pregnant, 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.
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Types Of Hrt Medication And Side Effects
Hormone replacement therapy comes in various forms, including tablets, patches, gels and creams. The effects of HRT vary from woman to woman – what is right for you will depend on the symptoms you are experiencing and should be discussed with your doctor.
HRT tablets are the most common form, with HRT patches following a close second. Both of these options are available in oestrogen-only and combined forms, and the patches are replaced every few days, while the tablets are taken every day.
Oestrogen is also available as a gel which is applied daily to the skin. Oestrogen pessaries that are placed in the vagina can help reduce local dryness, but do not tackle more general symptoms. Here’s an overview of the different types of hormone replacement therapy, including the benefits, risks and side effects of each:
|– Not enough studies to prove that this form of oestrogen doesn’t slightly raise the risk of blood clots, stroke, breast cancer etc.|
While HRT can be beneficial to menopausal women, there are risks with each type of medication. If you’re considering it, speak to your GP who will advise you on the best type for you.
Venous Thrombosis And Hrt
Venous thromboses are blood clots that form inside veins. Women under 50 years of age, and women aged 50 to 60, face an increased risk of venous thrombosis if they take oral HRT. The increase in risk seems to be highest in the first year or two of therapy and in women who already have a high risk of blood clots. This especially applies to women who have a genetic predisposition to developing thrombosis, who would normally not be advised to use HRT.
Limited research to date suggests the increased risk of clots is mainly related to combined oestrogen and progestogen in oral form, and also depends on the type of progestogen used. Some studies suggest a lower risk with non-oral therapy or tibolone.
Other Treatments For Menopausal Symptoms
Studies have shown that some prescription medications can reduce hot flushes and sweats. These treatments may be an option if HRT cannot be used for health or other reasons, and should be discussed with a doctor.
The herbal medicine, black cohosh, may take the edge off hot flushes and sweats, but there is no data to support long-term use. There is also a rare liver condition that may be associated with the use of black cohosh.
Other complementary and alternative medicines have not been shown to be effective for menopausal symptoms when compared with dummy or placebo treatment in research studies.
Commercially available vaginal moisturisers may reduce vaginal dryness if used regularly. Consult your doctor about what will work best for you.
How Does Menopause Affect Hormone Levels
Menopause is not just about one moment when women do not have a period anymore. During this natural occurrence, there are three main stages. The first one is called perimenopause which lasts approximately 3-5 years. The symptoms of it, are irregular menstruation bleeding, hot flashes, night sweats, insomnia, and psycho-emotional disorders such as irritability, aggression, and even panic. Here the hormone levels start fluctuating.
The second stage is called menopause. It means there are no more periods, and a lady cannot give birth to children. Also, this stage is diagnosed only with a doctor after she was 12 months straight without menstrual bleeding. Here thelevels are decreased. And, the symptoms are the same, however, a woman can also experience memory problems, and decreased libido.
Finally, the last stage is the postmenopause. And, it lasts for the rest of your life. Nevertheless, all the stages are critical for ladies. Because hormonelevels during menopause are not stable, and they do not provoke symptoms only but may affect the development of a disease. For instance, nodes and polyps can occur in the uterus, benign fibroids in malignancies, and also, hormone levels in menopause may bring some discomfort in your intimate zone, such as vaginism.
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