News & Blogs
March 11 2020

Menopausal Hormone Therapy: Risks vs. Benefits


 
Menopause occurs when a woman’s menstruation permanently stops. This usually happens naturally beyond the age of 45, when the ovaries no longer produce the hormones estrogen and progesterone, making hormonal imbalance a massive part of menopause. A woman has reached menopause if she has not had her period in over a year.
 
However, besides the fact that they are no longer able to visit a hospital’s labor and delivery room to bear children, menopause comes with symptoms that most women would rather not experience.
 

Symptoms of Menopause

During perimenopause (the period leading up to menopause), a woman may experience the following uncomfortable symptoms:
 
  • Irregular, short menstruation cycle
  • Hot flashes
  • Night sweats
  • Difficulty sleeping
  • Frequent mood swings
  • Unintended weight gain
  • Hair loss or thinning hair
  • Vaginal dryness
  • Chills
  • Loss of breast fullness
 
The intensity and frequency of these symptoms vary per woman. Some have a more difficult time dealing with these symptoms than others, so it is only understandable why they will try to find ways to relieve themselves of their discomfort.
 
There are women who can find relief from these symptoms through home remedies and non-medication treatments such as:
 
  • Avoiding certain foods that can trigger hot flashes, night sweats, and mood swings such as those that contain caffeine and alcohol, as well as sugary, spicy, and processed foods.
  • Exploring natural remedies such as ginseng, black cohosh, and red clover to reduce hot flashes
  • Maintaining a healthy weight through the right diet and exercise and drinking lots of water
  • Eating foods rich in calcium, vitamin D, protein, and phytoestrogens
 
While these can alleviate menopausal symptoms, not all women find them effective. For this reason, they turn to hormone replacement therapy (HRT).
 

What is Hormone Replacement Therapy?

Hormone Replacement Therapy (HRT), or menopausal hormone therapy, is an option for women to manage their menopausal symptoms. It is used to balance estrogen and progesterone levels around perimenopause and beyond.
 
It also puts a stop to the most common uncomfortable symptoms of menopause, like sweating and hot flashes. Plus, it reduces the risk of developing certain diseases in women.
 
There are two types of hormone replacement therapy: estrogen therapy and combination therapy.
 

1. Estrogen Replacement Therapy

The most effective treatment of troublesome hot flashes and night sweats is systemic estrogen, which comes in pill, cream, gel, skin patch, vaginal ring, or spray form. It can help ease the vaginal symptoms of menopause such as dryness, itching, burning, and discomfort during sexual intercourse.
 
  • Tablet – This is commonly taken to reduce symptoms of menopause, and doses vary per woman. It is usually taken once a day without food but can increase depending on the need.
  • Skin patch – The patch is placed in the abdominal area. This might need to be replaced every few days, again, depending on the dosage. Some patches do not treat menopause symptoms but are only used to decrease the risk of osteoporosis.
  • Topical estrogen – These are creams, gels, and sprays. When applied, the estrogen is absorbed and released through the bloodstream. Depending on the brand you use and dosage you are advised to take, it can be applied on the shoulder, arm, or legs.
  • Vaginal estrogen – This form of estrogen therapy is recommended for those who experience vaginal dryness, itchiness, or pain during intercourse. Vaginal rings need to be replaced every three months, while cream types may be applied directly onto the vagina on specific schedules.
 
Estrogen replacement therapy is prescribed to those who have either had a hysterectomy (the surgical removal of the uterus) or bilateral oophorectomy (the surgical removal of the uterus and ovaries).
 

2. Combination Hormone Therapy

Combination therapy is a mix of estrogen and progestin. Progestin is the lab-made version of the hormone progesterone. This type of HRT is recommended to those who still have their uterus intact. It lowers the risk for endometrial cancer and helps in alleviating discomfort associated with menopause. Like estrogen replacement therapy, it is administered in various ways.
 

Benefits of Menopausal Hormone Therapy

Women undergo HRT to lessen the impact menopause has on their bodies and improve their overall disposition. Here are some advantages to taking it:
 
  • Decreases incidences of hot flashes, night sweats, and vaginal dryness, along with poor sleep, mood swings, and “brain fog” that comes with it
  • Eases vaginal symptoms, such as thinning tissue and dryness, including painful sexual intercourse
  • Takes care of an overactive bladder, and perhaps recurring urinary tract infections
  • Reduces the risk of certain diseases such as osteoporosis, heart disease, and endometrial cancer
 
HRT is recommended for those who are experiencing moderate to severe menopausal symptoms or those who stopped having periods before the age of 40 (premature menopause).
 

Risks Involved When Undergoing HRT

While menopausal hormone therapy sounds like a great solution to overcoming menopause pains, not everyone is qualified to take it. It is important to note that these are lab-made hormones, which are drastically different from the ones the body naturally produces. Take note of the repercussions involved, as well:
 
  • An increased risk of developing breast cancer, but only if taken for more than a year
  • More susceptible to the formation of blood clots only if taken in the form of pills
  • For women over 60 years of age, estrogen pills are associated with a small increase in strokes.
 
While the risks vary depending on age, it is important to speak with a physician and get tested before taking HRT.
 

Consult Your Doctor Before You Proceed

Hormone replacement therapy is only one of the ways to deal with the symptoms of menopause, but it presents a lot of benefits for those who are qualified to take it. As with any treatment, it is best to have a discussion with your doctor and weigh the pros and cons if HRT is really for you.
 
If you are considering getting HRT, you may consult with an OB-GYN doctor or endocrinologist at Makati Medical Center to get yourself checked.