If you’re going through peri-menopause your peer group may have heated discussions about the pros and cons of hormone replacement therapy – and that’s because there’s plenty to talk about. While hormone replacement therapy can certainly help to ease some of the most troubling side effects of menopause – such as mood swings and vaginal thinning that leads to uncomfortable sex – they aren’t always necessary. As with any medication – natural or synthetic – we prefer to err on the conservative side, only administering treatment if absolutely necessary.
On the other hand, if menopause symptoms are negatively impacting your daily routine, family life, overall well-being or relationships – by all means, you should schedule an appointment with us here at Women’s Health Associates so we can review your medical history and see if hormone replacement therapy is right for you.
Different forms of hormone replacement therapy (HRT)
There are two different forms of hormone therapy:
Systemic hormone therapy
Systemic or bioidentical hormones are ingested or absorbed by the body (typically pill, patch, cream, gel or spray forms). These treatments make their way into your bloodstream where they work to regulate hormone balance. While systemic HRT is the most effective remedy for hot flashes and night sweats. Versions that include estrogen can also help to ease vaginal symptoms. If you have weathered the storm of the former but are suffering from the latter, you’re probably better off using a different form of treatment – such as MonaLisa Touch, a hormone-free way to correct vaginal side effects of menopause.
Keep in mind that long-term use of systemic hormone replacement therapy is never recommended. If you do choose to use hormone therapy, it should be viewed as a temporary solution and hormone levels and other relevant screenings should be provided by your doctor at routine intervals so you can wean off the treatments over time.
Also, depending on which form you use – progesterone, estrogen or combo- treatments, there is a risk of:
- Heart disease
- Blood clots
- Breast cancer
Low-dose vaginal products
These forms of HRT come in ring, tablet or cream form. As the name suggests, they are low-dose and are absorbed by vaginal tissues, keeping effects relatively localized. Low-dose vaginal products are recommended most often for women with vaginal symptoms as well as potential, minor relief from incontinence.
Again, at WHA, we recommend most women speak with their doctor or midwife about MonaLisa Touch because it is specifically designed to treat thinning vaginal tissues by generating new collagen, elastin and vascularization. Another benefit of MonaLisa touch is that women with or who have survived breast cancer can benefit from relief without the risk of estrogen therapy.
You are a candidate for hormone replacement therapy IF…
In most cases, we like patients to see if they can weather the natural hormone imbalance storm without treatment if they can. The HRT industry is huge- and very profitable – so the term hormone imbalance is used widely and – often incorrectly to coerce people into thinking they need a treatment they’d be better off without.
Sure, hormones fluctuate a bit as your body makes the transition from a fertile women who ovulates, to a menopausal woman who no longer ovulates and no longer has a period. However, the shaky ground in between those two normal, healthy phases is often survivable without treatment. In fact, living a healthy lifestyle is one of the best things you can do to naturally treat and reduce the symptoms of menopause.
You may consider yourself a candidate for hormone treatment if:
- Hot flashes and night sweats are so extreme that they are causing serious discomfort and/or embarrassment in public, or sleep is so compromised it’s taking its toll elsewhere in your life.
- Normal lubrication and vaginal toning exercises aren’t doing the trick for making sex more pleasurable.
- Your lack of libido or physical discomfort/pain during sex is taking its toll on your relationship.
- Feelings of irritability, depression, anxiety or insomnia seem more extreme and/or have lasted longer than they have for others in your peer group.
- Your doctor is concerned about rapidly diminishing bone mass (although most doctors now recommend taking medications called bisphosphonates, rather than using estrogen).
- You started menopause before the age of 40, which we call early menopause.
It’s important to note that early menopause puts you at greater risk for a myriad of health issues related to menopause, including heart disease, type 2 diabetes, osteoporosis and Parkinson’s. If you begin to skip periods in your later-30s or early-40s, do mention it to your general physician as well as your gynecologist.
Still on the fence about whether hormone replacement therapy is the right move for you? Come on in to Women’s Health Associates. We’ll be happy to make recommendations based on our conversation and examination in combination with personal and family medical histories.