Hot flashes, mood swings, night sweats, sleeplessness – all are among the symptoms of female menopause. One solution is hormone therapy, in which women are supplemented with hormones including estrogen and/or progesterone.
This treatment may not be right for every woman, so consider these questions to determine if it is an option to discuss with your doctor.
1. Why would I use hormone therapy?
There are 43 common symptoms of menopause, says Dr. Henry Hess, author of “The Perfect Menopause: 7 Steps to the Best Time of Your Life.” Hormone therapy can be tailored to fit each woman’s individual needs and comes in a variety of forms, including patches, sprays, creams and suppositories.
The severity of your symptoms can dictate whether you need hormone therapy or might be better served trying other therapies first, he says.
2. Are there risks to using hormone therapy?
In 2002, the Women’s Health Initiative conducted a clinical trial that indicated use of Prempro, a combination estrogen-progestin, might increase a woman’s chance of developing breast cancer, heart attack, stroke and blood clots.
However, the risk to an individual is small – out of 10,000 women taking the drug, there were only eight more cases for stroke and breast cancer, seven for heart disease, 18 for blood clots, compared with women who didn’t take the hormone.
3. Am I comfortable taking hormones?
Dr. Mary Jane Minkin, author of “A Woman’s Guide to Menopause and Perimenopause,” says that each woman needs to decide how bothersome her symptoms are and how she feels about intervention.
Minkin believes that if a woman is stressed out about using hormone therapy, other available options might be better, such as antidepressants for hot flashes and irritability, or a zero-risk hormone cream for vaginal dryness.
4. Is my practitioner qualified to treat menopause?
“They just don’t teach this in medical school or residency, and that’s a problem,” Hess says. Do your homework and find “someone interested in menopause and spending the time working with you.”
Minkin stresses finding a practitioner you’re comfortable with, as some menopause symptoms can be embarrassing to discuss. A list of certified menopause practitioners can be found at menopause.org, home of the North American Menopause Society.
5. What other changes can I make to relieve my symptoms?
Before medication, try modification, Hess says. Look at your nutrition and exercise regimen to see if perhaps extra weight or poor diet choices may be contributing to feelings of sluggishness.
To ward off hot flashes, Minkin recommends wearing layers of clothing, keeping your environment cool, and laying off known triggers like hot or spicy food and red wine.
6. What is my medical history?
Dr. Kent Holtorf, diplomate and board examiner for the American Academy of Anti-Aging Medicine, says a review of your family medical history is important to see if you are already at risk for breast cancer, blood clots, heart attack or stroke. If so, you need to discuss those risks with your practitioner to determine if hormone therapy is the best option given the risks involved.
7. How long would I have to use hormone therapy?
Like all aspects of hormone therapy, individualization of care is the key, Minkin says. Most of her patients receive treatment for two to three years, but some have gone five or even 10, she says.
Tapering off hormones is best, Minkin says. If your symptoms return, you can stay on the dosage just above when the symptoms recurred, she says.
Sidebar
Natural alternatives for menopause relief
While hormone therapy is considered the gold standard in treating menopause symptoms, some women choose to find relief through herbs and lifestyle changes.
Dr. Henry Hess believes in a blend of traditional and natural medicine, as well as exercise like yoga or qui gong, to find relief. But even natural therapies need to be monitored.
“Any herbs have potential for liver damage,” he says, making regular blood tests with your health practitioner a must.
According to the National Center for Complementary and Alternative Medicine, “very little well-designed research has been done on (complementary and alternative medicine) therapies for menopausal symptoms.”
As herbal medications are not regulated by the FDA or other governing body, the amount of any herb within a compound can vary widely from brand to brand. Hess recommends visiting Consumerlab.com, which evaluates nutritional supplements in a laboratory environment.
Though the government does not endorse the use of botanicals to treat menopause symptoms, there are some that have been in common use long enough to have gained popularity and some recommendation from doctors:
Black cohosh: This herb is an ancient Native American remedy, Dr. Mary Jane Minkin says. She recommends the brand Remifemin as the only preparation that has guaranteed amounts of black cohosh as it is manufactured in Germany where botanicals are regulated. Black cohosh reportedly aids in reducing hot flashes and night sweats.
Soy: Used for relieving hot flashes, soy can be found in tofu, edamame and soy milk. Minkin claims that there is no word for “hot flash” in Japanese and it is thought that’s because Japanese women have a high soy intake. However, scientific literature includes both positive and negative results on soy extracts for hot flashes, according to NCCAM.
Ginseng: While not found helpful with hot flashes, ginseng has a good track record for aiding in mood symptoms and sleep disturbances, the NCCAM states.
author: Tara Kingston