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When To Stop Hrt After Menopause

Post Menopausal Hormon Replacement Therapy

Heart Attack After Stopping HRT – 180 | Menopause Taylor

How prevalent is heart disease among women?

Female Reproductive Organs

Cardiovascular disease is NOT just a mans disease. Cardiovascular disease is the Number 1 killer of women over age 25 in the United States, regardless of race or ethnicity. Once a woman reaches the age of 50 , the risk for heart disease increases. In young women who have undergone early or surgical menopause, the risk for heart disease is also higher, especially when combined with other risk factors such as:

  • Diabetes
  • Elevated LDL cholesterol
  • Low HDL cholesterol, sometimes called “good” cholesterol
  • Obesity
  • Family history of heart disease

What is menopause?

Menopause is a normal stage in a womans life. The term menopause is commonly used to describe any of the changes a woman experiences either before or after she stops menstruating. As menopause nears, the ovaries gradually produce less estrogen , causing changes in the menstrual cycle and other physical changes. The most common symptoms of menopause are hot flashes, night sweats, emotional changes and changes in the vagina .

Technically, menopause is the end of a womans reproductive cycle, when the ovaries no longer produce eggs and she has her last menstrual cycle. The diagnosis of menopause is not confirmed until a woman has not had her period for six to twelve consecutive months.

How is heart disease associated with menopause?

What can be done to reduce the risk of heart disease for menopausal women?

Can Increase The Risk Of Blood Clots

Studies have shown that HRT may raise your risk of blood clots and stroke. This risk may be highest for people over 60 or who started menopause over a decade ago. The longer you take HRT, the greater the increase in your risk.

Because of this risk, health experts recommend the lowest possible HRT dose for the shortest period of time for people over 60 or who are 10 years past the onset of menopause.

What Are The Risks Of Hrt

The health risks of HRT include:

  • Increased risk of endometrial cancer For women who have had a hysterectomy , this is not a problem
  • Increased risk of breast cancer with long-term use
  • Increased risk of cardiovascular disease
  • Increase in inflammatory markers
  • Increased risk of blood clots and stroke, especially during the first year of use in susceptible women

All women taking hormone replacement therapy should have regular gynecological exams . The American Cancer Society also recommends that women over age 50 should:

  • Perform breast self-examination once a month
  • Have a breast physical examination by her health care provider once a year
  • Have a mammogram once a year
  • Don’t Miss: Estrogen And Dizziness

    Healthy Woman: Hormone Withdrawal Woes

    N E W Y O R K — Five years ago, hormone therapy was recommended to postmenopausal women almost as a matter of course as a way to protect them from age-related disease and to improve their overall quality of life. How times have changed.

    In mid-2002, a major study revealed hormone therapy that combined estrogen and progestin increased heart disease and breast cancer risk and didn’t affect well being. Prescriptions for hormone therapy dropped from 90 million to an estimated 57 million within a year.

    Then, later data from the study, the so-called Women’s Health Initiative, or WHI, showed risk of dementia doubled in women 65 and older who were taking postmenopausal hormone therapy. Prior to this finding, some women were taking hormones, in part, because they were under the impression that it might prevent Alzheimer’s disease.

    Now, just this week, the estrogen-only phase of the WHI was ended prematurely because not only did it not effect risk of heart disease, but also because it raised the risk of stroke. Even more women are now likely to discontinue hormone therapy.

    Yet coming off the hormones is not always easy for women. It’s estimated that about a quarter of women who stop hormone therapy resume taking them to ease debilitating withdrawal symptoms such as hot flashes. Quitting is especially difficult for women who have been taking hormones for 10 years or more.

    Dealing With Side Effects

    Alternatives To Hormone Therapy For Menopause ...
  • 1Exercise regularly. Exercise can help improve sleep and give you more energy. Do moderate to vigorous cardio 2-3 times a week. You can also do weight lifting and other strength training once or twice a week to protect your bones.XTrustworthy SourceNational Health Service Public healthcare system of the UKGo to source
  • If you are going through menopause, exercise can reduce hot flashes.
  • If you have recently stopped taking testosterone or estrogen, you may be at increased risk of weight gain. You can use exercise to maintain or lose weight.XResearch source
  • 2Undergo a bone mineral density screening. While HRT can prevent osteoporosis in menopausal women and transgender men, transgender women may be at higher risk of bone loss while on it.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source Furthermore, once you are off HRT, your risk of osteoporosis may return. Once or twice a year, visit your doctor for a screening to make sure that your bones are healthy.XResearch source
  • In most cases, your doctor will scan your bones using a DEXA machine to determine your risk of getting a bone fracture.
  • Staying active and taking supplements with calcium and vitamin D may be able to help protect your bones.XTrustworthy SourceNational Health Service Public healthcare system of the UKGo to source
  • Antidepressants may help with hot flashes, but they have side effects such as dizziness, anxiety, agitation, and a reduced sex drive.
  • Read Also: Endometrial Thickness Of 7mm After Menopause

    When Should I Stop Hrt

      Taken to relieve the symptoms of menopause, Hormone replacement therapy or HRT aims to restore female hormone levels by replacing small doses of oestrogen and progesterone in the body.

      Most women are able to stop taking HRT after their menopausal symptoms finish which is usually around 5 years after they start. Women on a low dose of HRT should be able to stop as soon as they wish but those on a higher dose should gradually decrease their HRT dosage over a few months rather than stopping suddenly.

      Understanding The Benefits And Risks

      Recent findings show that although not completely risk-free, HRT remains the most effective solution for helping with symptoms of menopause and is also effective for the prevention of osteoporosis. It may also provide protection against heart disease.

      When deciding whether to have hormone replacement therapy , it is also important to understand the risks.

      You may have heard about a link between breast cancer and HRT. Guidelines from the National Institute for Health and Care Excellence say that HRT is effective and recommend that it should be offered to women with menopausal symptoms.

      Also Check: How To Get Rid Of Menopause Apron

      Personal Growth & Finding Your Voice

      So many women tell me that gain a different understanding of the world as they move through menopause. They begin to realize that the saying what other people think about me is none of my business really is true other peoples opinions matter far less than how they feel about themselves. Women are digging deep and come out the other side with inner wisdom that isnt possible without all the life experience. Menopause is like a second adolescence, a time of intense growth and discovering what truly matters. I encourage women to try new things and discover passions they may not have had time to pursue in the past. I discovered ballroom dance and have the confidence to train hard and compete in front of large crowds something I never would have done in my younger years!

      In this phase of life, women are learning that its time to speak up about what is important to them. They wont settle for the status quo. Though it may take time to let go of guilt or fear around speaking up, women are realizing that they deserve to be heard.

      Can I Take Menopausal Hormone Therapy After Breast Cancer

      When to STOP Taking Estrogen Replacement Therapy for Menopause – 88

      When women reach menopause, some choose to take PHT, which is made up of female hormones to help reduce menopause symptoms. But doctors have been concerned about women who have had breast cancer using PHT, because of the known link between estrogen levels and breast cancer growth.

      A well-designed clinical trial found that breast cancer survivors taking PHT were much more likely to develop a new or recurrent breast cancer than women who were not taking the drugs. Because of this, doctors generally do not recommend PHT if a woman was previously treated for breast cancer.

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      Continuing Hrt After :

      “My GP tells me he has patients in their 80s who are still on HRT and, as long as they are happy and healthy and have regular checks, he is happy for them to continue. Needless to say, I am back on a very low dose and feeling great.”

      “I am 68 and suffer very badly with hot flushes. I had patches for many years, but the doctors are reluctant to prescribe them to me now.”

      “I would rather take it and face minimal risks than suffer the awful symptoms which were ruining all aspects of my life.”

      “HRT gave me my life and my marriage back.”

      Benefits Of Postmenopausal Hormone Therapy

      Among the various hormonal imbalance symptoms that can be alleviated with hormone replacement after menopause are:

      • Local irritation
      • Among others

      Side effects should be reported to an overseeing doctor as soon as possible. Dosages may be reduced, or a different treatment type may be pursued depending upon their severity, among other options.

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      Mht For Women In Menopausal Transition

      Menopausal transition refers to the period from the moment of increased variation in menstrual cycle until the moment immediately prior to the last day of menstruation. It varies among individuals and is a period that often includes vasomotor symptoms such as hot flushes alongside frequent or excessive menstruation. Hot flushes vary among individuals but may appear from 1 year to 3 years prior to the last day of menstruation and are especially severe around the last day of menstruation. They may even last for several years. Approximately 75% of women aged between 45 years and 55 years suffer from symptoms of menopause, which may lead to low self-esteem, sleep disorder, and feelings of decreased energy. To evaluate the ovarian reserve during menopausal transition, measuring the serum level of anti-mullerian hormone , day 3 follicle-stimulating hormone , estradiol , and ovarian antral follicle count using pelvic ultrasonography is possible, but they are not used as indicators for predicting menopause. Additionally, because the function of the ovaries changes during this period, it is advised not to conduct a hormone test for menopause diagnosis .

      Hormone therapies for treating the symptoms of menopause during menopausal transition are combination therapy of levonorgestrel releasing-intrauterine system with oral or percutaneous estrogen, low-dose combined oral contraceptives , and estrogen√Ęprogestogen therapy .

      Menopause Symptoms And Hrt

      6 Effects of Menopause on Your Body

      Menopause symptoms that may be relieved by HRT include:

      • hot flushes and night sweats
      • vaginal dryness
      • hair loss or abnormal hair growth
      • dry and itchy eyes.

      Other therapies, including vaginal oestrogen products, antidepressants or other medications, may be used depending on the symptoms and risk factors. Seek advice from your doctor.

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      Hrt: Benefits And Risks

      Although there have been concerns raised about HRT and the potential risks to various aspects of womens health, more recently published findings show that although not entirely risk free, it remains the most effective solution for the relief of menopausal symptoms and is also effective for the prevention of osteoporosis. It may in certain age groups provide protection against heart disease.

      This leaflet sets out the known facts about HRT. It summarises the results of studies regarding its safety and addresses the controversy that still surrounds it, together with current thinking about its suitability. It is written specifically for women wishing to know about HRT. Our medical advisory panel strongly recommends that you should discuss with your doctor both the benefits and the risks of HRT on an individual basis. The types of HRT available are listed below.

      Hrt For Breast Cancer Survivors

      It is advisable for women with a history of breast cancer to avoid HRT unless other treatments are ineffective, and their quality of life is made intolerable by menopausal symptoms. In these circumstances, HRT should only be prescribed in consultation with the womans breast surgeon or oncologist.

      Evidence has not conclusively shown that HRT will increase the risk of breast cancer recurring in a woman with a history of the disease. However, oestrogen and progestogens may stimulate some types of cells in the breast and some types of HRT use have been associated with an increase in the risk of breast cancer in women without a history of breast cancer.

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      Effects Of Stopping Hormone Replacement Therapy

      Side effects of stopping hormone replacement therapy include the return of menopause symptoms, especially hot flashes. If there are symptoms, they may be more manageable than before HRT. Some women experience uncomfortable symptoms after stopping HRT with little relief. Unfortunately, its impossible to tell ahead of time who will be affected the most.

      Stopping HRT may affect your bone health. The estrogen in HRT helps protect your bones by preventing bone loss, which can lead to . Once you stop taking estrogen, you may develop brittle bones. However, lifestyle, dietary and nonhormonal medications can be very effective in preventing bone loss and osteoporosis.

      Women who stop taking HRT may have a lower risk of developing . The effect of stopping HRT on the risk of is not clear, but the risk of developing is lower.

      If you need help deciding on when to start or stop HRT, ask your gynecologist about the most up-to-date guidelines for HRT and how they relate to your personal and family health history.

    • Sanchez CK, Rumbellow S. Hormone Replacement Therapy for Menopausal Symptoms. US Pharm. 2018:43:21-26.
    • HRT: Benefits and risks. Womens Health Concern.
    • Hormone therapy: Is it right for you? Mayo Clinic.
    • Venous Thrombosis And Hrt

      I Stopped Taking HRT (Hormone Replacement)… Here’s What Happened!

      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.

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      Menopausal Hormone Therapy After Breast Cancer

      Taking post-menopausal hormone therapy , also called hormone replacement therapy , to help with menopause symptoms may not be safe for women who have had breast cancer. If you are bothered by menopause symptoms, talk to your doctor about other ways to get help.

      Many women have menopause symptoms such as hot flashes after treatment for breast cancer. This can happen naturally as women get older, but it can also be caused by breast cancer treatment. Some pre-menopausal women have menopause symptoms as a result of chemotherapy or from hormone therapy drugs used to treat breast cancer . Women who are past menopause might also get symptoms if they had to stop taking PHT.

      Hormone Therapy And Other Treatments For Symptoms Of Menopause

      D. ASHLEY HILL, MD, and MARK CRIDER, MD, University of Central Florida College of Medicine, Orlando, Florida

      SUSAN R. HILL, MD, Orlando, Florida

      Am Fam Physician. 2016 Dec 1 94:884-889.

      Patient information: See related handout on treating menopausal symptoms, written by the authors of this article.

      Menopause is the physiologic transition when the ovaries stop releasing eggs, ovarian function decreases, and menstrual periods stop. Although some women go through the menopausal transition without symptoms, many women have hot flashes or genital tract symptoms, such as vulvar or vaginal dryness, painful intercourse, and urinary problems. When counseling patients who are going through menopause, clinicians should understand the benefits and risks of hormone therapy, nonhormonal prescription medications, and alternative treatments, and be familiar with the various delivery methods.


      After a median of 13 years of follow-up, women taking combined estrogen/progestogen therapy in the Women’s Health Initiative trial had a significantly increased risk of breast cancer and venous thromboembolism, and a reduction in hip fractures.

      In 2014, a consensus conference endorsed new terminology: the term genitourinary syndrome of menopause replaces the terms vulvovaginal atrophy and atrophic vaginitis. This is partly because older terminology does not encompass the extent of genital tract symptoms that many women experience.

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      What Happens After Menopause A Look At Concerns And Celebrations Postmenopause

      Women come to my office all the time afraid they are entering menopause. The women in their early 40s are even more fearful that theyre heading toward the transition. They are mortified that the BIG CHANGE is creeping up on them far earlier than they anticipated. But more often that not, they are afraid of what comes next what happens after menopause. So many woman today are caught up in worrying about postmenopause. These women arent even aware that this stage of life can bring amazing changes and incredible freedom to their lives.

      The years after menopause can stretch out like a road without an end. A womans average life expectancy is so much longer than it used to be. Sometimes women fear these years will stretch out endlessly with nothing to look forward to. But nothing could be further from the truth and Ill explain how this is possible.

      I have helped so many women navigate menopause and come out the other side feeling better than they ever have. But what makes them that way? Lets take a deeper look at what happens after menopause and when you are considered postmenopausal.


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