Friday Q&A: Menopause & Hormone Replacement Therapy (HRT)
Answering your questions about HRT; non-hormonal treatments for menopause; HRT risks after age 60; & side effects from birth control pills vs. HRT.
ICYMI 👉
Question #1 (about the pros and cons of hormone therapy) is free for all subscribers. Questions #2-4 (on non-hormonal treatments; HRT after age 60; & birth control vs. HRT) are for paid subscribers only. If you would like a paid subscription but it’s not in your budget, please message me directly!
Click here to submit your questions (about anything) for future Q&A posts!
Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.
QUESTION #1: SHOULD I TAKE HORMONES?
I feel like everyone is talking about their menopause these days. I am 55 and in good health. I haven’t had a period in 3 years but I feel pretty much like myself. Sometimes I get sweaty at night but it’s not too bad. Am I missing out by NOT taking hormones?
-Sally from Louisville, KY
Dear Sally,
Great question. Menopause is defined as having done a full year without a menstrual period—or, in the case of non-menstruating women—when symptoms and/or laboratory testing reveals that the ovaries are no longer producing robust amounts of estrogen and progesterone. Women who are transitioning into menopause—and those who already are there—may experience a range of symptoms, and to varying degrees. These include hot flashes, night sweats, joint pains, muscle stiffness, vaginal dryness, urinary tract infections, increased urinary frequency, low libido, pain with sex, fatigue, forgetfulness, moodiness, irritability, heart palpitations, dry skin—among others.
Some women will experience significant symptoms; others will sail through menopause without issue. When a woman experiences symptoms that interfere with her quality of life and when the benefits of hormone therapy outweigh the risks, the most effective way to treat symptoms caused by declining or absent hormones is by taking hormone therapy. Just like any medical intervention, however, hormone replacement therapy carries risk.
So: the question of how to treat your particular symptoms hinges on the potential risks and the likely benefits of hormone therapy for you (and only you). Because some of the symptoms are subjective (i.e. quantifying stiff joints, hot flashes, or irritability is more difficult than, say, measuring cholesterol), a decision about hormones should include quality of life issues in addition to measurable data.
It’s also important to remember that there are long-term benefits of hormone replacement therapy, beyond simply treating immediate symptoms. HRT has been shown to reduce the risk for osteoporosis, premature heart disease, and early cognitive decline—among other things.
In other words, there are risks of taking hormones; there also are risks of not taking hormones. (Click here for the most recent expert guidelines that nicely capture the risk-benefit ratio of hormone replacement therapy. And be sure to talk with your doctor.)
Note: My piece about hormone replacement therapy is here. My longer conversation with women’s health expert, Dr. Mary Claire Haver, is here.
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QUESTION #2: NON-HORMONAL TREATMENTS FOR MENOPAUSE
What are some solutions to menopause ailments (stiff joints, hot flashes) for women who are advised by their doctors to NOT take hormone replacement because of their various health issues?
- Katharine
Dear Katharine,
Here are some non-hormonal tips to treat the symptoms you described:
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