Hormone therapy helps with the symptoms of menopause because it addresses the falling estrogen levels that are causing issues. It’s a complex topic and requires a careful conversation with your provider.
Regional One Health’s certified menopause practitioners have expertise in treating menopausal women and can help you navigate whether hormone therapy is right for you.
Hormone therapy has proven effective in treating many symptoms of menopause. Still, it’s a complex topic that requires careful consultation with your doctor.
Diane Todd Pace, PhD, APRN, FNP-BC, NCMP, FAANP, FAAN is a certified menopause practitioner at Regional One Health. When she talks to patients about hormone therapy, it’s a risks-verses-benefits conversation.
“The benefits are much more likely to outweigh the risks if you start before age 60 or within 10 years of starting menopause,” she said. “It is by far the most effective treatment for hot flashes, which are the most common menopause symptom, and it also helps with many other symptoms.”
Pace outlined the basics to help women discuss the option with their provider.
What is hormone replacement therapy?
Diane Todd Pace, PhD, APRN, FNP-BC, NCMP, FAANP, FAAN is a certified menopause practitioner at Regional One Health. She talks to patients about the risks and rewards of hormone therapy.
As you approach menopause, your body makes less estrogen and progesterone.
Hormone replacement therapy does exactly what its name implies: replaces hormones your body no longer makes with synthetic hormones. It can be delivered by pill, patch, cream or ring.
How do I know which type of hormone therapy is right for me?
This is a question you need to discuss with your provider. However, there is one key consideration for all women: whether they still have their uterus.
“If you still have your uterus, you can’t be on unopposed estrogen,” Pace said. “You need to use an estrogen/progesterone combination to avoid the risk of uterine cancer.”
If you had a hysterectomy to remove the uterus or surgery to remove both the uterus and ovaries, your provider may suggest management by estrogen only.
What symptoms does hormone therapy help?
It addresses symptoms related to decreasing estrogen levels, like hot flashes, vaginal dryness and pain during intercourse.
It also can help lower your risk of serious issues like osteoporosis. Other benefits directed toward your health will be discussed by your provider.
Are there any side effects?
Hormone therapy can cause bloating, breast tenderness, headaches, nausea, vaginal bleeding and mood changes.
Hot flashes are one of the most common symptoms of menopause. Hormone therapy can help because it replaces the lost estrogen that causes hot flashes and other symptoms.
A provider who has experience treating menopausal women can help find the product that works best for you and the lowest effective dose.
Can it increase my risk of breast cancer?
Pace said this is the top question she hears. It is a complex issue and is likely due to the information that got a lot of publicity from a large women’s health research study that was conducted in the past. Dr. Pace points out that there is a difference between having an increased risk and causing cancer.
Pace said although there is a link between increased breast cancer risk and hormone therapy, there is also a link between increased breast cancer risk and drinking two glasses of wine daily, being sedentary, being obese and having gone to college. The point is, “Just because you have a risk doesn’t mean there is a cause and effect.”
She said women on hormone therapy can decrease their overall risk of breast cancer by addressing other risk factors related to healthy lifestyle– i.e. eat better and start exercising.
Also, hormone therapy patients are required to undergo screenings that detect breast cancer early, when it is treatable: “You have to get your mammogram, or we won’t refill your hormone therapy prescription,” Pace said.
What if I have a family history of breast cancer?
It by no means precludes you from using hormone therapy.
Pace said if a very close family member – mom or sister – had breast cancer young, it might be a reason not to go on hormone replacement therapy. However, in cases where the family member is a more distant relative or was older when they were diagnosed, it might not pose a problem. Dr. Pace said she always discusses the risks with patients during their appointment.
Hormone therapy is a great option for many women. It can address not only symptoms of menopause, but lower the risk of serious conditions like osteoporosis.
What factors would preclude me from hormone therapy?
Some medical issues tip the scales so that the benefits of hormones don’t outweigh the risks:
- Previous heart attack or stroke
- Previous pulmonary embolism
- History of problems taking oral contraceptives
How do I learn more?
Have an honest conversation with a provider who has expertise in menopausal care. As a certified menopause practitioner, Dr. Pace can educate patients about their choices to help them find the best option for their individual needs: “Shared decision-making with our patients is the philosophy of our practice,” she said.