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5 things to know about menopausal hormone therapy


5 things to know about menopausal hormone therapy

Menopause marks the end of women’s reproductive years, but it’s not an instantaneous process. Estrogen and other hormones decrease four to eight years before a woman’s last menstrual period.
When that happens, women can experience symptoms such as:

  • Hot flashes
  • Irritability and anxiety
  • Night sweats
  • Sleeping difficulties
  • Mood changes
  • Brain fog

Dr. Gauri Dhir, an endocrinologist at Tidelands Health Endocrinology in Myrtle Beach, says menopausal hormone therapy can help ease the transition.
“Menopausal hormone therapy is generally safe for most women. However, as with any treatment, it’s important to talk with your health care provider about your specific risk factors before starting a hormone regimen,” she says.
Here are some key facts to know about hormone therapy.

1. HRT vs. MHT

Hormone therapy after menopause used to be called Hormone Replacement Therapy (HRT), a term now used to describe the treatment of girls and women younger than 40 who need to replace estrogen due to Turner’s syndrome, early menopause or primary ovarian insufficiency, which is when the ovaries stop functioning as they should.

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By contrast, menopausal hormone therapy (MHT) refers to a low-dose treatment intended to alleviate symptoms associated with menopause. MHT is for women who have transitioned to menopause and are in their 50s or older. The goal is to taper off MHT over three to five years as symptoms of menopause improve.

2. Estrogen and progesterone

Estrogen and progesterone are hormones that regulate the female reproductive system and naturally decrease during menopause. To help alleviate symptoms of menopause such as hot flashes, women can supplement the amount of estrogen in their bodies. However, women who have a uterus must also take progesterone. Otherwise, her risk of developing uterine cancer increases.
Women who have had a hysterectomy and no longer have a uterus can take estrogen alone.

3. Delivery systems

MHT is available in several delivery systems:

  • Oral hormones are taken as a pill.
  • Transdermal patches are worn on the skin and replaced every few days.

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  • Local estrogen (tablets, creams or rings) is placed directly in the vagina to help relieve dryness and irritation.
  • Birth control pills may be recommended for women who experience symptoms before menopause and still need contraception to prevent unintended pregnancies.

4. No weight gain

Menopausal hormone therapy does not cause weight gain. Instead, it promotes healthy lifestyle choices, Dr. Dhir says.
“It can help you feel better, which makes it easier to establish and sustain healthy habits like sleeping well, exercising regularly and eating a balanced diet,” Dr. Dhir says. “Estrogen can also help reduce the amount of the stress hormone cortisol that’s in your body, which can help you feel less irritable and give you an improved outlook.”

Insurance coverage

Many private health insurance companies and Medicare cover MHT, but every plan is different. Specific plans may not cover some types and formulations of hormone therapy, so be sure to check with your insurer before you begin treatment.

Dr. Gauri Dhir is a board-certified physician who provides a range of care to treat diabetes, obesity, thyroid disorders, osteoporosis and adrenal and pituitary disorders. 

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