The most widely used prescription to treat menopause-related changes is hormone replacement therapy (HRT), either a combined progesterone/estrogen treatment for women who still have their uterus or estrogen therapy for women who have had a hysterectomy. Both of these methods can reduce hot flashes, night sweats, bone loss and vaginal dryness. HT can also help reduce the risk of osteoporosis and fractures.

Women who have experienced “natural” menopause (non-surgical) and still have their uterus are usually placed on a combination of estrogen plus progesterone to prevent cancer of the uterus that can be caused by the use of estrogen alone.

However, there are risks involved in taking HRT. These include:

• Increased risk of blood clots in legs or lungs
• Gallbladder disease requiring surgery
• Increased risk of stroke
• Increased risk of heart disease
• Increased risk of breast cancer with prolonged use
• Increased headaches
• Uterine bleeding
• Urinary incontinence
• Dementia in women over 65

The risks are rare in women under 60, but because there are no overriding long-term health benefits, it is recommended that women use the lowest dose of hormones that treats their symptoms and that they use hormones for a short amount of time. You should discuss the benefits and risks of HT with your doctor and consider your overall health when making a decision

Who should NOT take MHT for Menopause

Women who:

• Think they are pregnant
• Have problems with undiagnosed vaginal bleeding
• Have had certain kinds of cancers (such as breast or uterine cancer)
• Have had a stroke or heart attack
• Have had blood clots
• Have liver disease
• Have heart disease

The Women’s Health Initiative (WHI)

A major study called the Women’s Health Initiative (WHI) has looked at the effects of MHT on heart disease and other health concerns. It has explored many questions relating to MHT, including whether MHT’s effects are different depending on when a woman starts it. Future research may tell experts even more about MHT. For now, MHT should not be used to prevent heart disease, memory loss, dementia, or Alzheimer’s disease. MHT sometimes is used to treat bone loss and menopausal symptoms. Learn more about MHT research results in Facts About Menopausal Hormone Therapy – National Heart, Lung, and Blood Institute.

Sources

• Menopausal Hormone Therapy – National Heart, Blood and Lung Institute 
• Menopause – PubMed Health
• Menopause and Menopause Treatments Fact Sheet – Women’s Health.gov 
• Hormone Replacement Therapy – MedlinePlus.gov

For more information:

Go to the Menopause health topic.