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 No matter how much you have been warned about 'the change,' nothing prepares you for the rollercoaster ride of emotions and physical changes that occur during menopause. Between the ages of 45 and 55, just about the time you are finally settling into your life and what you have made of it, along comes the mother of all whammies. Your body decides its time to stop being fertile and slowly produces less and less of the hormones that make having a baby possible. Technically, a woman is said to have reached menopause when she stops menstruating for 12 months in a row. However, the process of menopause is not as simple as that. Along with the cessation of your periods comes along a bundle of other changes and for many women this time can be truly chaotic. Along with dealing with ideas of your femininity to adjusting to a new phase of life ahead, you may also have to struggle with not so pleasant menopausal symptoms such as hot flushes, night sweats, headaches, mood swings, depression, anxiety, loss of libido, and insomnia.

For the longest time, the best way to tackle the problems of menopause has been hormone replacement therapy or HRT. Since reduced hormone levels are the root cause of all menopausal symptoms, HRT addresses the issue by artificially increasing the levels of estrogen in the body. Some forms of HRT include estrogen along with another hormone progestin while others are purely estrogen-based. A few decades ago, HRT was regarded as not only a miracle cure for all things menopausal but also the best way to prevent chronic diseases associated with menopause such as heart disease and osteoporosis. Doctors prescribed HRT freely and the treatment was administered to post-menopausal women as well. In the late 90s however, this rug was effectively pulled out from under our feet. New research showed that HRT was the not the magic formula for menopausal distress. While it could lessen symptoms such as night sweats and hot flushes, the long-term side effects could be more damaging. Studies were popping up everywhere about how HRT when taken in tablet form could result in blood clotting and breast cancer. Suddenly, the idea of struggling with a few months of night sweats and insomnia seemed infinitely more appealing.

When the dust of the debate for and against died down, one thing became clear. Not every woman would benefit from HRT. Additionally, not every woman should be prescribed HRT. If HRT is being prescribed to only prevent thinning bones or memory loss, there are other better medicines that can do the same and with lesser risks. There is also no denying that there is a definite risk that HRT may increase a person’s chance of developing cancer, blood clots and gall bladder disease. This risk reduces when progestin is added to the therapy in addition to estrogen but to be doubly sure, any form of hormone therapy should be used at the lowest effective dose and for the shortest period of time possible.

So, when do you need estrogen therapy? Well, if symptoms such as hot flashes, vaginal dryness and thinning bones are unbearable, HRT can help as long as you come with a clean bill of health prior to menopause. Women who think they may be pregnant, have had certain types of cancers or strokes and heart attacks, are prone to blood clots, have suffered from liver disease or complain of vaginal bleeding should not take estrogen therapy for menopause. HRT administered in the form of patches or gels (versus pills) are also recommended if you have high cholesterol, are a smoker or are overweight. If you do decide to go ahead with HRT, the best way to manage the risks is to keep a close eye on your health both during and after menopause. Regular breast checks and mammograms should be conducted and blood pressure and cholesterol checked routinely. Alternative treatments for menopausal symptoms such as herbal remedies may also be helpful. In addition, a healthier lifestyle that includes daily exercise, a low-fat diet, and no smoking or drinking goes a long way towards reducing the risks associated with menopause.

References:

1. http://www.fda.gov/forconsumers/byaudience/forwomen/ucm118624.htm

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