Hormone Therapy for Menopause

Menopause marks the time in a woman’s life when her ovaries stop producing enough hormones to keep up the menstrual cycle. Over time, ovulation and menstruation stop, and estrogen levels drop.

Menopause is normal, but the hormone changes that drive it can cause symptoms that may affect a woman’s physical health, mental health, and quality of life. As a result, many women choose to receive hormone replacement therapy for menopause.

What Are Common Symptoms of Menopause?

Menopause isn’t the same for every woman, and it doesn’t happen overnight. Women and many medical providers may have a hard time recognizing the link between symptoms and menopause or perimenopause. Many menopausal symptoms can result from a number of other non-hormonal health conditions.

Common symptoms of menopause can vary from woman to woman, as can their severity. Night sweats and hot flashes are well-known symptoms. However, there is a long list of hormonal symptoms that do not get as much attention, including:

  • Accelerated bone loss.
  • Anxiety.
  • Bloating.
  • Brain fog.
  • Breast tenderness.
  • Constipation.
  • Depression.
  • Dry skin and itchy ears.
  • Hair loss.
  • Headaches.
  • Insomnia.
  • Joint pain.
  • Painful sex.
  • Vaginal dryness.
  • Weight gain.

These symptoms and others can come and go. Though some are only bothersome, others can mean a big difference in quality of life.

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How Do You Know You’re in Menopause?

Menopause starts with perimenopause, which includes a gradual onset of symptoms usually for women in their 40s. During perimenopause, estrogen begins to drop, and cycles can become irregular.

Some women also feel hot flashes, mood swings, and decreased sex drive. Perimenopause occurs about three to five years prior to menopause. Perimenopausal women can still get pregnant.

Roughly 85% of women experience menopausal symptoms during this transition. According to Rebecca Thurston, PhD, a University of Pittsburgh psychiatry professor who studies menopause, many don’t get the treatment they need. This is an oversight Dr. Thurston regards as one of the great blind spots of medicine.

“It suggests that we have a high cultural tolerance for women’s suffering,” Dr. Thurston said. “It’s not regarded as important.”

Menopause is underway when a woman has missed a period for 12 consecutive months. Although every woman is unique and will experience this differently, most women enter menopause in their early 50s.

Treatment for Menopause

Lifestyle changes can help alleviate many of the unwelcome symptoms of menopause for the high percentage of women who experience them.

Treatments include behavior changes, nonhormonal treatments, and some alternative (complementary) medicine treatments. They include:

  • Eating balanced meals that include a protein, a fat, and a carbohydrate.
  • Avoiding processed foods that can spike blood glucose levels.
  • Eliminating caffeine, alcohol, and refined sugars.
  • Taking vitamins and supplements.
  • Exercising regularly.
  • Getting enough sleep.
  • Speaking with a mental health professional.
  • Practicing meditation and mindfulness.

Making healthy changes can improve overall health. They can also help women:

  • Maintain a healthy weight.
  • Preserve bone and muscle mass.
  • Have more energy.
  • Experience fewer mood swings.
  • Manage stress.

Hormone replacement therapy is a valuable tool for when lifestyle changes alone are not enough to relieve symptoms.

What Is Hormone Replacement Therapy for Menopause?

Hormone replacement therapy (HRT) is a treatment that aims to relieve the symptoms of menopause. It replaces the female hormones produced at lower levels during perimenopause and menopause.

Conventional HRT includes an estrogen and progesterone component to mimic hormones created by the human ovary. It can alleviate and even stop many menopausal symptoms. It can also protect women from osteoporosis and decrease their risk of diabetes.

HRT for menopause is not new. It was the most common treatment in the U.S. until 2002 when the Women’s Health Initiative published findings citing potential adverse effects.

How Is Hormone Replacement Therapy Administered?

Hormone replacement therapy is systemic so that it circulates through the bloodstream to address a host of symptoms. It can also locally target symptoms such as vaginal dryness.

Hormone therapy for menopause can include:

  • Oral tablets.
  • Gels, sprays, creams, and patches.
  • Injections.
  • Vaginal rings.

Is Hormone Treatment for Menopause Right for You?

According to the North American Menopause Society, medical organizations devoted to the care of menopausal women agree on the importance of hormone therapy. They suggest there is no question it can manage symptoms for healthy women during the menopause transition and in early menopause.

And overall, the benefits may greatly outweigh the risks for most patients. Ongoing research will continue to provide more information going forward.

Like any treatment, HRT has risks and potential side effects. Women who are at high risk of certain cancers, heart disease, and other conditions should discuss risks and benefits with their doctor.

The doctors at the UPMC Magee-Womens Midlife Health Center have expertise in caring for women in perimenopause and menopause. To ask a question or make an appointment at one of our convenient locations, call 412-641-8889.

Susan Dominus. Women Have Been Misled About Menopause. The New York Times. LINK.

Gina Harper-Harrison; Meaghan M. Shanahan. Hormone Replacement Therapy. NIH. LINK.

The North American Menopause Society. Hormone Therapy: Benefits & Risks. LINK.

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.