Hormone Therapy: Fact or Fiction?Menopause Pages

1. Fact or fiction? Estrogen Therapy (ET) is an option all women can consider at menopause.

     Fiction: Only women who no longer have a uterus should consider using ET. For women with a uterus, the option they might consider is estrogen plus progestogen therapy (EPT). Progestogen is needed to protect the uterus and balance the effects of estrogen. Using Estrogen Therapy (bio-identical or Western medicine)  alone for 5 or more years can more than triple the risk of developing cancer of the uterus, but adding progestogen prevents the uterine lining (endometrium) from thickening and greatly reduces the cancer risk. Then, of course, each woman must determine (with her healthcare provider) if EPT is right for her.

2. Fact or fiction? Estrogen is government-approved as a hormone therapy treatment for menopause symptoms.

    Fact: Several pills, patches, a vaginal ring and ET gel, are approved by the FDA  for treatment of the symptoms of moderate to severe hot flashes and vaginal atrophy, as well as for the prevention of osteoporosis.

3. Fact or fiction? Using ET or EPT causes permanent weight gain.

     Fiction: Neither ET nor EPT causes permanent weight gain. Some women may experience temporary weight gain from water retention. Increasing fluid intake, limiting salt consumption, and participating in regular physical activity will help reduce water retention.

4. Fact or fiction? Hormone therapy (HT; either ET or EPT) provides immediate relief of menopause symptoms.

     Fiction: Some women experience rapid relief of symptoms, but others can take 6 or 8 weeks or more to experience the full effect of a given dose or type of HT. Also, side effects will have stabilized and often been diminished by this time.

5. Fact or fiction? Estrogen is the only hormone used to treat menopause symptoms.

     Fiction: Progestogen alone has sometimes been used during perimenopause to treat symptoms such as hot flashes, but its most common use is to protect against the increased risk of uterine cancer associated with ET. Combined estrogen-progestogen birth control pills during perimenopause can also help reduce symptoms while providing contraception until menopause is reached. Testosterone therapy has also been prescribed for symptoms, usually for fatigue and decreased interest in sex, especially for women who have had their ovaries removed. Many experts think that testosterone should always be used with estrogen to maintain an appropriate balance of the two hormones.

6. Fact or fiction? Women who experience early menopause (at or before age 40) have more reasons to consider hormone therapy than women who reach menopause at the typical time.

     Fact: Due to the additional health risks experienced by women who go through premature menopause, hormone therapy is often recommended. Furthermore, these women should consider full-dose estrogen rather than lower doses until they reach the average age of menopause (age 51), at which time the decision to continue hormone therapy should be reevaluated. In fact, fewer health risks are seen in treated women than in untreated women.