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With constant hot flashes and night sweats as an ever-present reminder, menopause can be impossible to ignore.
That is why many women choose to seek out a hormone doctor to prescribe medication to alleviate the symptoms.
But for many women, taking hormone replacement therapy drugs can do more harm than good. How do you know if you are one of these women? And what other questions should you have for your hormone doctor?
Keep reading to find out the answer to these questions and more.
1. What Are the Stages of Menopause?
Natural menopause consists of three distinct phases.
The first is called perimenopause. It's the transition phase between when your menopause symptoms first started, and one year after your last menstrual period.
Once a year has passed, the start of menopause can be confirmed by your hormone doctor. This is the second phase and symptoms can last for years. During this time many women choose hormone replacement therapies to relieve their discomfort.
Fortunately, eventually your symptoms will subside and you will enter a postmenopause stage.
2. What Kinds of Hormone Therapy are Available?
Many women use hormone replacement therapy to maintain their body's balance as they go through menopausal changes. There are two different kinds of treatment available from your hormone doctor.
The first is an estrogen-only option. Estrogen is the name for the hormone that controls many aspects of female reproduction.
It can provide a lot of relief for patients suffering from menopause, especially those who have had to have their uterus removed due to a hysterectomy.
The other treatment option your hormone doctor might recommend is an estrogen plus progestogen therapy. Progestogen is another hormone found in the female body. It is used in menopausal medications to protect women who still have their uterus from developing uterine cancer by taking estrogen alone.
3. Should I Choose an Estrogen-Only Therapy?
Estrogen-only therapies are meant for women who have had a hysterectomy. They should not be taken by women who still have their uterus intact because it can increase their risk of developing certain kinds of cancer.
4. How Can I Take My Hormones?
Generally, replacement hormones can be consumed in two different ways. The first is with systemic products that can circulate through your bloodstream delivering medication to all parts of your body.
Systemic products are available in multiple forms including:
- Oral Tablet
These products are used to control hot flashes and night sweats and relieve vaginal discomfort.
The other option you have is to use a localized product. These are creams, rings, or tablets that are used to control the vaginal symptoms of menopause.
5. What Dose Should I Start With?
When you first start your therapy, your hormone doctor will begin with the lowest dose possible that is consistent with your goals. The doses vary widely based on individual circumstances.
Women that start hormone replacement therapy close to menopause have the least risk of adverse reactions. This is typically around the age of fifty to sixty. As women age, it becomes more dangerous to begin a replacement regimen.
If a woman has to go through early menopause, and she has no history of breast cancer, then she can take replacement hormones until age 51.
When you go to the hormone doctor, they will talk to you about your symptoms and what kind of relief you expect to obtain.
6. What are the Benefits of Hormone Therapy?
There have been hundreds of studies done on the effectiveness of hormone replacement therapy.
Over and over again they have proven that estrogen (combined with progestogen, or without) can treat hot flashes, vaginal dryness, night sweats, and even bone loss.
7. Are There Any Risks With Hormone Therapy?
As with many things, the longer you use hormone replacement therapy, the more likely you are to have a complication. There are some serious health risks associated with continuing treatment long-term.
Both estrogen-only and progesterone and estrogen treatments have been associated with increases in blood clots and have the potential to cause a stroke. These risks are increased for women who smoke or are over the age of sixty.
8. How Do I Stop Taking Hormones?
Many women are able to discontinue hormone replacement therapy without much difficulty. But for a minority of women, it can be a real challenge.
There are two approaches to discontinuing the medication, either you quit cold turkey or you taper off by reducing your dosage or the frequency at which you take your medication.
In surveys, the majority of women said that they discontinued their medication cold turkey after using it for five to twelve years.
For the women who chose to taper off the medicine, they found that they had fewer symptoms of menopause after coming off the medication than those who quit abruptly.
9. What Studies are Available on Hormone Replacement?
The most famous study that has been done on hormone replacement was conducted by the Women's Health Initiative.
It was conducted with 27,000 women where some of the women were given estrogen-only treatment, others were given the progesterone and estrogen option and a third group was given a placebo.
The study wanted to look at the way the hormone replacement drugs affect a women's body long term.
In 2002, the study was discontinued because researchers believed that the therapy was putting women at a greater risk of developing breast cancer, having a stroke, or being diagnosed with heart disease.
These findings were frightening for many women who became fearful of hormone replacement treatment options, choosing instead to suffer the symptoms of menopause.
However, years later a follow up was done on participants of the study and it was published in a recent medical journal. This review showed that there was no overall increase in the death rates of women who had taken the medication.
This means that the long-term net effect of the drugs may be insignificant. This suggests that many women can benefit from hormone replacement therapy.
10. What Factors Should I Consider Before Starting Hormone Replacement?
Despite any health risks, estrogen is still the most effective way to treat the symptoms of menopause.
If you are a healthy person and you are experiencing severe menopause symptoms then hormone replacement therapy may be right for you. It is especially important for women who have experienced early menopause or had a hysterectomy to start some kind of medication.
Women whose periods stopped before the age of forty have higher risks of developing osteoporosis, heart disease, or anxiety and depression without hormone replacement therapy.
11. Is Hormone Therapy Safe?
When it comes to hormone replacement therapy, there have been mixed opinions on safety. Although there are many benefits of the treatment, it does increase your risk of developing certain cancers.
You should discuss with your hormone doctor how your menopause symptoms are affecting your life to make the right decision considering your own personal risk factors.
12. Who Should Avoid Hormone Replacement Therapy?
Hormone replacement therapy can do more harm than good to certain groups of women. Typically, the younger you are when you start the medication, the less likely you are to have an issue with it.
Older women have shown higher incidences of negative effects from the therapy. Women who smoke should also avoid taking any estrogen-based medication. They have an increased risk of developing blood clots or heart disease.
13. Does Hormone Replacement Affect Death Rates?
It has been highly publicized that hormone replacement therapy can be dangerous for a lot of women.
But investigations and recent studies have shown that women who take estrogen-based medication do not have a higher death rate than those who dealt with their menopause symptoms naturally.
14. When Should I Stop Taking Hormones?
Fifty-one is the average age of menopause onset and the most severe symptoms can last for two to three years before you start to feel like yourself again. But there are no rules about how long your symptoms might last.
Your hormone doctor will recommend that you consider the severity of your symptoms as well as the potential risks of the medication before you begin treatment.
Then they will prescribe you low dose treatment options for up to five years without excessive concern. After that time, you shouldn't need the medication anymore as your menopause symptoms should have subsided.
Some women continue to have symptoms for longer than this. But studies have been done on women who have taken hormone replacement therapy for more than twelve years without serious side effects occurring.
15. Have Other Patients Been Satisfied With Hormone Replacement?
Many women find that the benefits of hormone replacement therapy greatly outweigh the potential risks. Estrogen is the best way to manage the symptoms of menopause.
For women who suffer from intense hot flashes and other forms of discomfort, the medication makes sense.
Finding a Hormone Doctor
Now that you know a little more about hormone replacement therapy and what questions you should ask your hormone doctor, you're ready to make an appointment.
Check out our listings of bioidentical hormone experts in your area and start feeling better today.
Published: April 10, 2018
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