Menopause and Hormone Replacement Therapy

Women between the ages of 45 and 55 who suffer from mood swings, hot flashes, headaches, weight fluctuation and forgetfulness may be in the throes of menopause.

Often called the "change of life," menopause occurs when a woman's body slows its production of two hormones, estrogen and progesterone, and menstrual periods stop. After menopause, a woman's body produces about one-sixth as much estrogen as before menopause.

One of the first signs of menopause is a change in menstrual cycles. And more than half of all women will experience hot flashes.

What Can I Do to Minimize the Symptoms of Menopause?

Numerous treatments are available through your personal physician to drastically reduce or perhaps eliminate many of the problem symptoms of menopause. One option is hormone replacement therapy (HRT), which is also known to stabilize or reduce the risk of certain health problems that occur as women age, including osteoporosis, high blood pressure and heart disease. (Estrogen raises a woman's level of good cholesterol -- high-density lipoproteins or HDLs. Other studies, however, have shown that patients who take a combination of estrogen and progesterone have higher levels of bad cholesterol -- low-density lipoproteins or LDLs.)

HRT can be part of the treatment used to relieve:

  • Vaginal dryness
  • Hot flashes
  • Pain or burning sensation during intercourse
  • Heavy perspiring
  • Skin dryness
  • Sleep disruption and insomnia
  • Dizziness and headaches
  • Urine infection and incontinence
  • Early and rapid bone loss

How Much Will I Need?

Your dose depends on the severity of your symptoms. A blood test can show how much HRT you need to relieve your symptoms and prevent bone loss. The amount of HRT needed to relieve symptoms may not be enough to prevent bone loss.

If you smoke or take thyroid hormones, phenobarbital or drugs for convulsive disorders, you may need a higher level of HRT.

If you still have your uterus, you will cycle estrogen with progesterone. That means you will have monthly periods. This combination HRT prevents hyperplasia, the collection of precancerous cells associated with uterine cancer.

What Are HRT's Side Effects?

Using HRT, a woman continues to have monthly periods -- as long as estrogen is cycled with progesterone. If you take estrogen and progesterone daily, menstrual bleeding usually stops after six or seven months of therapy.

Other minor side effects include occasional spotting, weight gain, headaches, dizziness, breast tenderness and -- when used in larger doses -- increased blood pressure.

What About Uterine Cancer?

The risk for uterine cancer is the same for all women -- even those taking HRT -- as long as estrogen is taken with progesterone when needed. The risk for uterine cancer is one in 1,000 women.

Who Should Not Take HRT?

You should not take estrogen if you have a history of:

  • Breast cancer
  • Stroke
  • Blood clots
  • High blood pressure

Talk with your physician about any problems you may have had with birth control pills.

What Should I Do Next?

Talk with your physician and be frank about your symptoms. Together you can determine the best treatment option for you that can help minimize the discomforts of menopause. No therapy is appropriate for every woman. Discuss your need for HRT with your physician.