By the year 2025, the number of postmenopausal women is expected to rise to 1.1 billion. We need to support women on this journey as they transition to this stage of life. Many women experience hot flashes, night sweats, vaginal dryness, and other physical changes with menopause. For some women, the symptoms are mild and do not require any treatment. For others, symptoms are moderate or severe and interfere with daily activities.
It is so much more than helping treat hot flashes and night sweats - this is about your longevity. Your bone health, your cardiovascular health, and your brain health.
So what is hormone replacement therapy?
Hormone replacement therapy, now known as menopausal hormone therapy, involves taking estrogen at a dose high enough to raise the level of estrogen in your blood (but not to premenopausal levels) so that it can treat hot flashes and other symptoms. If you have a uterus, it is important that you are also taking a progestogen because this helps make sure the uterine lining does not increase in thickness. If vaginal dryness or pain with intercourse is your main symptom, then you can use low doses of estrogen as a cream and directly apply to the vulvar/vaginal areas. These low doses generally do not raise blood estrogen levels above postmenopause levels and it is important to note that they do not treat hot flashes.
There is no cure for menopause because it isn’t a health disorder – it’s a regular, natural part of life for most women. Using treatments to try to delay your menstrual cycle or try to regulate it during the menopause transition should not be a goal. Hormone therapy is designed not to eliminate menopause entirely, but to ease its symptoms.
You may have heard of the term “bioidentical hormone replacement therapy.” What does this mean? Bioidentical refers to the fact that the hormone being used is identical to the one your own body produces. It is sometimes confusing because patients will think that it needs to be compounded at a pharmacy to be bioidentical, but that is not true. There are a lot of commercially available products that are bioidentical. For example, a transdermal estrogen often used in hormone therapy, known as EstroGel, is made of 17B-estradiol, which is bioidentical to our own estrogen and is FDA-approced for use in menopause.
Hormone therapy remains the most effective treatment for hot flashes and night sweats and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. GSM symptoms are highly prevalent, affecting approximately 27% to 84% of postmenopausal women. The most commonly reported symptoms include irritation
of the vulva, inadequate vaginal lubrication, burning, pain during urination, pain during sexual intercourse, and vaginal discharge. In a survey of approximately 3000 women living in the US, women reported that their vulvovaginal atrophy symptoms:
Led to some loss of intimacy (85%)
Detracted from enjoyment of sex (59%)
Interfered with their relationship (47%)
Negatively affected sleep (29%)
Adversely affected general enjoyment of life (27%)
There are many options to explore with your healthcare practitioner. You can book your complimentary call today.
Benefits of Hormone Therapy include improvements in:
The risks of hormone therapy differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. This is why it is important to have a thorough assessment with your practitioner.
Are you interested in exploring whether menopausal hormone therapy is right for you?
My initial 75 minute assessment is a thorough health assessment and I will walk you through all the benefits and risks associated with hormone therapy so you can be confident if this is the right choice for you. Feeling confident in your health decisions and knowing the risks associated with a treatment is a very important part of your care. If you would like to first book a complimentary call to discuss my approach, you can book your call here.
To learn more, visit the North American Menopause Society here.