Hormone Therapy for Menopause: What It Treats, Who Should Avoid It and the Risks

Menopause is the time in a woman's life when her periods stop — a normal part of ageing, when the body makes much less of the hormones estrogen and progesterone. Hormone therapy means taking estrogen, with or without progesterone (or a similar hormone, progestin), to replace some of what the body no longer makes and relieve symptoms.

What it treats

Hormone levels can swing in the years before and during menopause. For some women the resulting symptoms are mild and pass on their own; for others they are severe enough to disrupt daily life. Lower hormone levels can cause:

• hot flashes
• night sweats
• mood changes
• vaginal dryness
• pain during sex

Hormone therapy may relieve these, and may also help protect against osteoporosis.

Who should not use it

It is not right for everyone. Don't use it if you:

• are or might be pregnant
• have unexplained vaginal bleeding
• have had certain cancers
• have had a stroke or heart attack
• have had blood clots
• have liver disease

Discuss your medical history with your provider before starting.

Types and forms

• After a hysterectomy (removal of the uterus), providers may recommend estrogen alone.
• With a uterus still in place, they may recommend estrogen plus progesterone (or progestin).

Most forms are pills, but there are also skin patches, gels and sprays, and vaginal creams, tablets and rings. Your provider can help you choose.

Risks

For some women hormone therapy may raise the risk of:

• blood clots
• heart attack
• stroke
• breast cancer
• gallbladder disease

The risk depends on the type of therapy, how long it is used, and your health history and lifestyle. Weigh risks and benefits with your provider. If you use it, the usual advice is the lowest dose that helps, for the shortest time needed. Many providers suggest a check-in every three to six months at first, then yearly once treatment is working well.

Sources

• MedlinePlus, U.S. National Library of Medicine, "Hormone Therapy for Menopause," drawing on the Food and Drug Administration. https://medlineplus.gov/hormonetherapyformenopause.html
• Rewritten in hubnx's own words.