Treatments for Menopause

Who needs treatment for the symptoms of menopause?

For some women, many of their menopause symptoms will go away over time without treatment. Other women will choose treatment for their symptoms and to prevent bone loss that can happen near menopause. Treatments may include prescription drugs that contain types of hormones that your ovaries stop making around the time of menopause. Hormone therapy can contain estrogen alone or estrogen with progestin (for a woman who still has her uterus or womb). Estrogen therapy usually is taken by pill, skin patch, as a cream or gel, or with an intrauterine device (IUD) or vaginal ring. How estrogen is taken can depend on its purpose. For instance, a vaginal ring or cream can ease vaginal dryness, leakage of urine, or vaginal or urinary infections, but does not relieve hot flashes. If you want to prevent bone loss, you also should talk with your doctor about medicines other than hormone therapy that can help your bones.

What are the benefits and risks of hormone therapy?

Benefits: Hormone therapy can help with menopause by:

• reducing hot flashes
• treating vaginal dryness
• slowing bone loss
• decreasing mood swings and depression

DO NOT use hormone therapy to prevent heart attacks, strokes, memory loss or Alzheimer’s disease. Remember there also are other medicines that can help your bones.

Risks: For some women, hormone therapy may increase their chance of getting:

• blood clots
• heart attacks
• strokes
• breast cancer
• gall bladder disease

For a woman with a uterus, taking estrogen alone, without progesterone, increases her chance of getting endometrial cancer (cancer of the lining of the uterus). Adding progesterone to the hormone therapy lowers this risk.

Hormone therapy also may cause these side effects:

• bleeding
• bloating
• breast tenderness or enlargement
• headaches
• mood changes
• nausea

Who should NOT take hormone therapy for menopause:

Women who…

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

So, what have we learned about taking hormone therapy for menopause?

We know that hormone therapy may be a way to get over the symptoms of menopause if taken for only a short time and in the smallest amount. Hormones do NOT help prevent heart or bone disease, stroke, memory loss or Alzheimer's disease. If you decide to use hormones, use them at the lowest dose that helps and for the shortest time needed. Check with your doctor every 3 to 6 months to see if you still need them. Because there are both benefits and risks linked to taking them, every woman should think about these in regard to her own health and discuss these issues with her doctor. We are still trying to learn more about the long- and short-term effects of hormone therapies on women's health. For more information on the risks and benefits of hormone therapy, go to http://www.nhlbi.nih.gov/health/women/index.htm.