Let’s first discuss what menopause is and what are some common symptoms. Next, we will examine the updated research on hormone replacement therapy for perimenopause and menopause as well as some natural approaches to managing menopause without hormone replacement therapy.
Menopause
Menopause is not a disorder but a normal part of aging. How menopause affects someone depends on the person, though symptoms are expected during the transition. Certain medications and lifestyle factors may help alleviate menopause symptoms.
What is menopause?
Menopause is the transition when your menstrual periods stop. Your period may become irregular before menopause, which is called perimenopause. You are not considered past menopause unless your periods have stopped for at least a year. After menopause, a person can no longer get pregnant.
What causes menopause?
As you get older, your ovaries wind down the production of the hormone estrogen, which causes irregular periods. Eventually, the ovaries stop producing estrogen altogether, although your body will continue to produce low hormone levels. Estrogen has many functions, and menopausal symptoms result from much lower estrogen levels. Sometimes, other medical conditions and lifestyle factors can cause menopause to occur before age 45.
What symptoms are caused by menopause?
Many people notice emotional and physical changes during menopause, but the severity of symptoms impacts people differently. The most common symptoms are:
– Irregular periods right before menopause
– Hot flashes, which can include flushing and night sweats
– Difficulty sleeping
– Less interest in sex
– Vaginal dryness that can make sex uncomfortable
– More urinary tract infections (UTI) and/or urinary incontinence
– Mood changes, including mood swings and irritability
– Weight gain, especially around the waist
– Loss of breast fullness
– Bone loss which can lead to osteoporosis
– Varying bodily changes such as aches and pains, thinner skin, or memory problems
Hormone Replacement Therapy for Perimenopause/ Menopause
Remember, menopause is a natural biological process that mustn’t be terrible! There are ways to manage menopause.
Pros of Hormone Replacement Therapy:
1. Symptom Relief: HRT effectively reduces hot flashes, night sweats, and vaginal dryness, providing immense relief to women experiencing these discomforts.
2. Bone Health: Estrogen replacement in HRT helps protect against bone loss and reduces the risk of osteoporosis, which is common during menopause.
3. Heart Health: HRT may improve cardiovascular health by increasing high-density lipoprotein (HDL) cholesterol levels and reducing some women’s risk of heart disease.
4. Improved Quality of Life: By alleviating menopausal symptoms, HRT can enhance a woman’s overall well-being, allowing her to enjoy a better quality of life.
A new study published in the medical journal JAMA concluded that the benefits of hormone therapy for the treatment of menopause symptoms outweigh the risks.
The new analysis is based on two decades of follow-up data from the Women’s Health Initiative study, which followed thousands of women taking hormone replacement therapy. The study was halted after it was found that women taking Prempro, which is a combination of estrogen and progestin, had higher risks of breast cancer and stroke.
After the initial findings were released, many women abruptly stopped hormone therapy, leading to a sharp decline in prescriptions. Many healthcare providers continue to hesitate in recommending hormone therapy. However, menopause experts now advocate for a reassessment, as much more is known today than two decades ago.
Most notably, various types of hormones that are safer are now available at lower doses.
An article published on NPR interviews the leading doctors and researchers. Below are the highlights from these interviews.
“Women should know that hormone therapy is safe and beneficial,” says Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine.
Reflecting on the past, Dr. Streicher notes that the Women’s Health Initiative study was flawed, and some identified risks were tied to the type of hormones administered.
“We learned what not to do,” Streicher explains. The type of progestin used, medroxyprogesterone acetate, was “highly problematic,” potentially contributing to the increase in breast cancer observed in the earlier study. “So we don’t prescribe that anymore,” Streicher adds.
Increasingly, other types of hormones, such as micronized progesterone, are being used because they do not increase the risk of breast cancer, says Streicher. Micronized progesterone is a bioidentical hormone with a molecular structure identical to the progesterone produced by women’s ovaries, and it tends to have fewer side effects.
Another issue with the study was the age of the participants. Most of the women were over 60, Streicher explains. “We now know there is a window of opportunity when it is safest to start hormone therapy and when you get the most benefit.” She adds that this window is typically between 50 and 60.
The Women’s Health Initiative study also identified an increased incidence of pulmonary embolism among women taking hormones. A pulmonary embolism is a blood clot that blocks blood flow to the lungs.
Streicher explains that taking estrogen orally, in pill form, may have heightened this risk. For those at risk of clots, a better option is to take estrogen through the skin via a patch, cream, or gel.
“The advantage of transdermal estrogen is that it is not metabolized by the liver,” Streicher says. “And because it’s not metabolized by the liver, we don’t see that increase in blood clots.”
With a range of hormone therapies now available, Dr. Streicher emphasizes that there is no one-size-fits-all approach. “Hormone therapy is beneficial well beyond just helping with hot flashes,” she says. Ongoing research suggests it may also protect against bone loss and heart disease.
Streicher advises women to discuss their options with their healthcare providers to determine what best suits their needs.
Hormone replacement therapy can be an effective option for managing menopausal symptoms and improving the overall quality of life. However, considering personal health history and preferences, weighing the pros and cons is crucial. Consulting with a healthcare provider is essential to determine HRT’s suitability and develop a personalized treatment plan. Regular reevaluation and monitoring are necessary to ensure hormone replacement therapy’s ongoing safety and effectiveness for menopause.
RELATED: Debunking Hormonal Birth Control Myths
How can I manage symptoms without HRT?
Natural Approaches to Managing Menopause Without Hormone Replacement Therapy
Menopause is a significant life transition for women, accompanied by various physical and emotional changes. While hormone replacement therapy (HRT) is a standard option, some women prefer alternative approaches. Fortunately, several natural strategies are available to manage menopause effectively without relying on HRT.
1. Lifestyle Modifications:
a) Healthy Diet: Incorporate a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Limit caffeine, alcohol, and spicy foods, which can exacerbate hot flashes.
b) Regular Exercise: Engage in physical activities like walking, yoga, or swimming to reduce menopausal symptoms, improve mood, and maintain bone health.
2. Alternative Therapies:
a) Herbal Remedies: Some herbs, such as black cohosh and evening primrose oil, have shown promise in alleviating hot flashes and mood swings. However, consult with a healthcare provider before starting any herbal supplements.
b) Acupuncture: This ancient practice may help manage menopause symptoms by promoting overall well-being and balancing hormonal changes.
3. Stress Management:
a) Relaxation Techniques: Incorporate stress-reducing activities like deep breathing exercises, meditation, or mindfulness to promote calmness and reduce anxiety.
b) Supportive Relationships: Seek support from friends, family, or support groups to share experiences, gain insights, and find emotional support during this transitional phase.
4. Symptom-Specific Strategies:
a) Hot Flash Relief: Dress in layers, keep the room cool, use a fan, and try cooling sprays or portable fans for immediate relief.
b) Vaginal Dryness: Use water-based lubricants or moisturizers to alleviate discomfort and enhance intimacy.
While hormone replacement therapy is a popular choice for managing menopause, it is not the only option. Incorporating lifestyle modifications, exploring alternative therapies, managing stress, and employing symptom-specific strategies can help women navigate this phase of life without relying on HRT. Every woman’s experience is unique, so it’s essential to consult a healthcare professional to determine the most suitable approach for managing menopause symptoms naturally. Embracing a holistic approach to well-being can empower women to navigate menopause with grace and confidence.
When will I reach menopause?
Most individuals assigned female at birth (AFAB) reach menopause in their 40s or 50s, with an average age of 51.
What is early menopause?
When menopause occurs before age 45, it’s considered early menopause. Early menopause occurs in about 5% of AFAB individuals. There can be many reasons for early menopause. Some causes include family history, surgery that removes the ovaries or uterus, radiation and/or chemotherapy, decreased estrogen and egg production, chemical imbalances, an autoimmune disorder, and smoking.
Menopause Resources
Read more at:
– American Congress of Obstetricians and Gynecologists Pamphlet on Menopause
– The National Women’s Health Information Center Menopause and menopause treatments Early menopause