Menopausal Hormone Therapy: Brief Version

Why is menopausal hormone therapy used?

When you go through menopause, you have fewer and fewer periods. After a few months or years, you stop having periods. Your ovaries no longer release eggs. Your body makes less of the female hormones estrogen and progesterone.

Menopause is part of getting older. You also go through menopause if your ovaries are taken out. For many women, the changes that come with menopause are not a problem. However, some women have a hard time because of the drop in hormones. If you are one of these women, it may help to take hormone medicine. This is called hormone therapy.

You can take the hormones in many different forms, including pills. If your uterus has been removed, you may take estrogen alone. If you still have your uterus, you need to take both estrogen and progesterone.

How can hormone therapy help?

Hormone therapy can help you get through menopause.
It may help take care of most of the symptoms of menopause, such as:

• Hot flashes.
• Sweating at night.
• Dryness in the vagina.
• insomnia
• decreased sex drive (libido)
• mood swings
• depression

Hormone therapy can help prevent and treat bone loss caused by osteoporosis.
Osteoporosis makes you more likely to have bone fractures. Bone loss starts at around age 35. It can get worse quickly around the time your periods stop. Hormones are one of the medicines that can slow down bone loss. Taking a different kind of medicine can also help. You also need to get regular exercise and make sure you get enough calcium.

Are there risks of taking hormones?

Depending on your age, treatment with estrogen and progestin may increase the risk for heart disease. It may also increase your risk for stroke, breast cancer, blood clots, some gallbladder problems, and possibly dementia. Also, estrogen taken without progestin increases the risk of uterine cancer if you still have your uterus. Discuss the risks and benefits of hormone therapy with your healthcare provider. It is important to know the risks of hormone therapy:

What are the side effects of hormone therapy?

Hormone therapy can cause side effects. You may notice that:

• You have bleeding if your uterus has not been removed.
• You have a vaginal discharge.
• You feel bloated, retain fluid, or gain weight.
• Your breasts are tender and larger.
• You have nausea.
• You have headaches and mood swings.
• You have abnormal blood clotting.
• You have more pimples on your face.

If you are taking both estrogen and progesterone, you may need to stop taking the hormones for a few days each month. Most of the time you will then have some vaginal bleeding. This bleeding lasts 2 or 3 days, most often without cramps or bloating. This is not a period. Tell your healthcare provider if you have bleeding any other time. If you take both estrogen and progesterone every day in low doses, you should not have bleeding. (You may have a little bit of spotting for just the first 2 or 3 months.)

Who should not take hormones?

If you have had or have now any of these health problems, you should not take hormones:

• Heart attack or stroke.
• Uncontrolled high blood pressure.
• Blood clots in your legs, lungs, or eyes.
• Vaginal bleeding that cannot be explained.
• Liver disease.
• Cancer of the breast or uterus.

You should also not take hormones if you are pregnant or think you may be pregnant.

If you have any of the health problems listed below, hormone therapy may make them worse. Make sure you tell your healthcare provider if you have had:

• Problems with fibroid tumors or other problems in your uterus.
• Breast disease of any kind.
• Migraine headaches.
• Gallbladder disease.
• High blood pressure
• Nerve pain or sensitivity to sunlight.

Also, if you smoke, it is not a good idea to take hormones.

What can I do to take care of myself?

If you are thinking about taking hormones:

• Talk to your healthcare provider about how hormones might help and what problems they might cause.
• Get a mammogram before you begin hormone therapy.

If you are already taking hormones:

• Do not change your hormone dose without checking with your healthcare provider first.
• Do not smoke.
• Eat healthy and exercise regularly.
• Have a mammogram every year. You should also check your breasts every month.
• Have a complete physical exam as often as your healthcare provider recommends.
• Talk with your provider if you have any problems.