Alternative Treatments for Menopause

Medically reviewed in December 2021

In 2002, the Women’s Health Initiative found that the risks of Premarin and Provera treatment for menopause outweighed the benefits. Since that time, women have been looking for alternative ways to treat their menopausal symptoms.

Bioidentical hormones have taken the place of Premarin and Provera. Bioidentical hormones are so named because they are identical to our natural hormones. The big question is, are they safe? The answer is yes and no. There have been no long-term studies in the United States, so we must look to Europe for some answers.

A study of nearly 100,000 women in France found that those on estrogen alone had a 30 percent increased risk of developing breast cancer. When estrogen was combined with natural progesterone, there was no increased risk for developing breast cancer. The researchers also found that giving estrogen in the form of a patch or gel led to no increased risk for blood clots. This may also decrease the risk for stroke or heart attack.

Most physicians would agree that treatment of symptomatic women in early menopause is relatively safe. Before starting hormones, it is important that you have a mammogram each year, and that the results are negative. In addition, your risk factors should be reviewed. For instance, I am very reluctant to start women on hormones when they have a mother or sister with a history of breast cancer.

Some doctors will not give women hormones under any circumstance. These doctors are often either men who have never had to live through menopause with their female friends or partners, or they are women who haven’t yet gone through menopause themselves.

If you are suffering and would like hormonal help, there are empathetic, understanding doctors out there. Find them. Have a full discussion so that you understand the benefits and the risks. We are all different. Some women may only need hormones for months and others may need them for years. There is no need to suffer, but make sure you are comfortable with your decision and that each year you re-evaluate your need for hormones.

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