Question

Menopause

Should I take hormone replacement therapy during menopause?

A Answers (3)

  • AMehmet Oz, MD, Cardiology, answered

    The decision to take hormone replacement therapy during menopause is a very personal one. It all depends on your symptoms, and how they impact your everyday life. But that’s not all. In the last few years, we’ve learned a lot about menopausal hormone therapies and their risks, which has made doctors reevaluate who they offer it to. But that doesn't mean no one should take it.

    If I see that a woman has disabling symptoms that are not helped by any non-hormonal measure or medication, I wouldn’t want her to suffer. If a woman has gone through menopause naturally at a normal age, and she has nothing in her health history that medically prohibits her from taking it, it is likely a reasonable choice if she wants it. We would choose the lowest dose for the shortest amount of time. And we would have her come in for a check-up every six months to a year to see if she still needs it and to make sure she hasn't developed any new health conditions that can increase her risk for problems.

    But for women who enter menopause before their mid-40s, the considerations are much different. These are women who may have premature ovarian failure (POF) causing them to enter menopause before 40, or women in early menopause, which occurs before age 45. This also includes younger women who had their ovaries removed surgically or damaged from cancer therapy. These women often take hormone therapy because their bodies have been deprived of estrogen for a long time, and that can bring on a host of other health problems. So hormone therapy in these younger menopausal women may actually be beneficial to their health in the long run. It’s such a personal decision, and one that should be guided by an informed doctor.

  • AStacy Wiegman, PharmD, Pharmacy, answered
    Taking hormone replacement therapy (HRT) during menopause is a personal decision that you should discuss with your doctor. Some women get symptoms during menopause, such as hot flashes, vaginal dryness, and night sweats, that can last months or years. If you don’t have these symptoms, or if they don’t bother you too much, there’s no need to take hormone replacement therapy. Some women prefer to try alternative therapies, such as eating more soy-based foods, using herbal remedies, exercising and practicing deep breathing.

    If you do try HRT, you’ll need to check in with your doctor every three to six months, or every year, so he or she can evaluate your progress and see whether you should continue taking the hormones. HRT comes with a long list of possible side effects, some of which are serious (increased chance of heart attack, stroke, blood clots, breast cancer), and some of which are less serious but still bothersome. Also, some women may not be candidates for hormone replacement therapy, including women with a history of stroke, breast cancer, liver disease or vaginal bleeding.
  • AKelly Traver, Internal Medicine, answered

    As far as hormone replacement therapy is concerned, the current recommendation is as follows: if you are really miserable in the first few years after menopause, short-term, low-dose hormone therapy is an option. Hormone replacement should be considered a temporary replacement to ease your body through the transition. Some women, about 5 percent, do continue to have hot flashes in their later years. If this is the case for you, quality-of-life issues need to be weighed against the small but present increase in the risks of breast cancer, heart attacks, and blood clots with hormone replacement.

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