Hormone replacement therapy in Menopause
Is it right for you?
Although 70 to 80 % of menopausal women experience symptoms, only 25% seek help.
Late perimenopausal and recently menopausal women can experience:
- Decreased sleep quality
- Difficulty concentrating
- Reduced quality of life
- Bone loss
- Increased risk of CVD and cognitive changes
- Vaginal dryness
- Urinary urgency and frequency
Options for treatment:
- Oral and transdermal estrogens
- If patient has intact uterus progesterone should be used with estrogen
- Ultra-low doses have been approved for prevention of osteoporosis
- Transdermal administration (patch) is preferable for women with obesity, elevated triglycerides or low libido.
Duration of treatment:
- There are conflicting recommendations depending on the medical society but in general: Discontinue in patients age 65 or older
- If use long term reduce dose
- Shortest duration for treatment goals
Candidates for treatment:
- Age <60
- Within 10 years of menopause
- History of stroke (personal)
- History of Heart attack (personal)
- High risk of breast cancer (self or first degree relative)
If you are experiencing bothersome menopausal symptoms discuss with your physician, you should have your options discussed.