Hormone therapy: The facts

One treatment that is often prescribed for the symptoms of menopause is hormone therapy.

Hormone therapy can help with the symptoms of menopause–hot flashes, night sweats, vaginal dryness and mood swings–but how do you know if it's right for you?

A normal part of aging is the start of menopause–another milestone in every woman's life. Menopause is considered official when your menstrual periods have stopped for one year. This usually happens sometime between the ages of 45 and 54 years. A woman can also go through menopause at an earlier age if she's had surgery to remove her ovaries.

Around the time of menopause, your body starts to produce less of the female hormones, estrogen and progesterone. When this happens, you may start to have some symptoms. Menopause is different for each woman–not everyone experiences the same symptoms. The most common ones include:

• Hot flashes and night sweats
• Vaginal dryness
• Trouble sleeping
• Mood swings

Estrogen also helps to keep your bones strong, and when estrogen levels fall, your bones become weaker and can break more easily. So, it's important to take steps to keep your bones strong and healthy (for tips, see our article on osteoporosis).

Sometimes, the symptoms of menopause go away after a few months without treatment, but there's no way to know if and when they'll stop. If your symptoms are bothersome, there are many treatments available, so it's a good idea to talk with your doctor about the options.

One such treatment that is often prescribed for the symptoms of menopause is hormone therapy.

How hormone therapy works

When a woman is on hormone therapy, she takes regular doses of estrogen alone or estrogen with progesterone to replace the falling levels of the hormones in her body.

Hormone therapy can be taken in several ways, including orally, through a patch on the skin, with a vaginal cream or gel, or with an intrauterine device (IUD) or vaginal ring. Your doctor will discuss which one is best for you based on your symptoms. For instance, if you are having vaginal dryness (but not hot flashes), you may be prescribed therapy as a vaginal cream or gel.

The schedule for what days you take the hormones varies depending on whether you've had a hysterectomy and need to take progesterone or progestin (the synthetic form of progesterone). The two common schedules are:

• Continuous-combined–estrogen and progestin every day
• Cyclic therapy–estrogen every day and progesterone or progestin added for 10-14 days out of every four weeks

Precautions

Like any medication, hormone therapy does carry some risks.

For many years, doctors believed hormone therapy was the solution for all the problems of menopause. They prescribed it routinely to cure their patients' hot flashes and mood swings, as well as to ward off heart disease and bone loss. However, several years ago a study known as the Women's Health Initiative conducted by the National Institutes of Health found that long-term use of hormone therapy may actually increase women's risk for heart attack, stroke, blood clots and breast cancer.

Since then, the U.S. Food and Drug Administration has set new guidelines for hormone therapy and advise that, in most cases, it should be used only for short-term treatment of menopausal symptoms. So, most doctors now believe you should use hormone therapy only if you really need it. And if you do decide to take hormones, plan on it being only for a short time. After this time, talk with your doctor about whether continuing therapy is right for you. Some women may need to continue therapy longer than a year, but only you and your doctor can make that decision.

Live long and healthy

Whether or not you decide to try hormone therapy, nothing is better for your body in the long run than doing the things that will help you stay healthy well into your senior years: get annual check-ups, maintain a healthy weight, eat well-balanced meals, stay physically active and don't smoke.