Hot flashes and night sweats. Laying in bed unable to fall asleep or waking up too early. If the symptoms of perimenopause are starting to drag you down, it may be time to talk to your doctor about hormone therapy.
Menopause vs. Perimenopause
Menopause is the phase in a woman’s life when her ovaries have stopped making the hormone estrogen and the menstrual cycle stops. Perimenopause is the time leading up to menopause when the amount of estrogen produced by the body fluctuates and causes the uncomfortable symptoms most women associate with menopause: hot flashes, difficulty sleeping, vaginal dryness and urinary tract changes.
“The transition through the perimenopausal and menopausal years can be very difficult for a lot of women. For women who have severe symptoms that interfere with daily living, hormone therapy can ease this transition,” said Paul Daskalos, DO, from Samaritan Gynecology & Surgical Associates.
According to the American College of Obstetricians & Gynecologists the average age of menopause is 51, while perimenopause may begin a lot earlier and can last up to 10 years.
How Hormone Therapy Works
Hormone therapy usually is a prescription medication that provides estrogen to help ease the uncomfortable symptoms experienced during this time frame when estrogen levels are too low.
Because estrogen can cause a thickening of the uterine lining and an increased risk of uterine cancer, women who have not had a hysterectomy and still have a uterus should also include progestin in their hormone therapy. Adding this hormone reduces the risk of uterine cancer.
A combination of estrogen and progestin or estrogen alone can be taken as a pill or skin patch, which delivers the hormones into the bloodstream. Dr. Daskalos reports this is the most reliable solution for hot flashes and night sweats.
For women whose primary problem is vaginal dryness, topical estrogen in the form of a cream, tablet or ring may help.
The length of time a woman takes hormone therapy depends on how long her symptoms lasts. The general recommendation is to be on the lowest, most effective dose as long as is needed to help reduce menopausal symptoms.
Side Effects, Risks & Benefits
According to Dr. Daskalos, hormone therapy maybe associated with a small increased risk of heart attack, stroke, deep vein thrombosis and breast cancer. Women who have a history of any of these conditions should discuss it with their doctor as it may impact the safety and effectiveness of hormone therapy.
Dr. Daskalos reports that bone loss occurs rapidly during perimenopause and can lead to osteoporosis. Hormone therapy has a protective effect against bone loss and can reduce the risk of hip and spine fractures. Estrogen also likely has a beneficial effect on reducing colon cancer risk.
“There are pros and cons to hormone therapy, so it’s definitely a discussion each woman should have with her doctor,” said Dr. Daskalos. “Her individual health, personal medical care philosophy and health history all play a role.”
Other Ways to Manage Menopause Symptoms
Hormone therapy isn’t right for everyone. For non-hormonal ways to manage menopause symptoms, look at lifestyle changes you can make like eliminating alcohol and smoking, and managing stress.
Dr. Daskalos suggests caution if you’re considering herbal supplements or bioidentical hormones from a compounding pharmacy.
“These items are touted as ‘natural,’ but it doesn’t mean they are better or safer,” said Dr. Daskalos. “There is a lack of good research on most of these products and there is always a risk of interaction with your current medications. The dosages of bioidentical hormones may also vary significantly from dose to dose”.
If you are interested in natural remedies, your doctor can help direct you to the most effective options.
Ready to get help for your menopause symptoms? Find an OB/GYN near you.
Learn 7 tips to help reduce the development of osteoporosis after menopause. Read more about menopause.