How should I use hormone replacement therapy (HRT) effectively?

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  1. Dr. Dawn Marcus
     
    Dr. Dawn Marcus answered:
    The following are recommendations for hormone replacement therapy during menopause:
    • Short-term use of hormone therapy can effectively treat menopause symptoms such as hot flashes. This is the primary reason why hormone therapy is used.
    • Short-term hormone therapy should be considered if you have moderate to severe menopause symptoms that are unresponsive to non-estrogen alternatives.
    • Hormone replacement may be used in women who are less than 60 years old.
    • Hormone therapy should be started within 10 years of your first menopause symptoms.
    • You should be treated with the lowest possible hormone dose to control your symptoms.
    • If your main symptom is vaginal dryness, consider using a vaginal preparation, to reduce the effects of hormones on the rest of your body.
    • Use hormone therapy for as short a time period as possible. Talk to your doctor every 6 to 12 months to determine if you should continue hormone therapy.
    • Short-term use of hormone therapy also prevents bone loss (osteoporosis), but many non-estrogen alternatives are available that work as well or better for osteoporosis and are associated with fewer risks.
    • Don't use hormone replacement for more than 10 years.
    • Don't use hormone replacement if you have had breast cancer, heart disease, or blood clots. You should also quit smoking before starting hormone therapy.
    • If you still have your uterus, you'll need to take progesterone in addition to estrogen.
    • Get regular annual mammograms while taking hormone therapy.
    • Consider effective non-hormone therapies such as antidepressants -- venlafaxine (Effexor) and paroxetine (Paxil), gabapentin (Neurontin), and clonidine (Catapres). Research studies have confirmed that these can be effective agents for perimenopausal symptoms.
    • Include helpful non-drug treatments: relaxation, stress management, yoga, and acupuncture.
    • Include these lifestyle changes for hot flashes: wear loose fitting clothing, dress in layers, use fans, exercise regularly, avoid hot and spicy foods, and limit caffeine and alcohol.
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    The following are recommendations for hormone replacement therapy during menopause: Short-term use of hormone therapy can effectively treat menopause symptoms such as hot flashes. This is the primary reason why hormone therapy is used.... More