Hormone Therapy for Menopause

The best way to have menopause diagnosed is by noting a continuous twelve month time frame without a menstrual cycle.  Prior to experiencing menopause woman go through a perimenopause.  Perimenopause is referred to as the time frame which is the onset of menopausal symptoms to the ceasing of menstrual cycles.  When menopausal symptoms first begin a doctor may order blood tests.  The blood tests can check the hormone levels in the patient.  However, the hormone levels do not mean a woman is in a menopausal state.  Hormone levels can vary in each woman on a daily basis.  This means you can have high levels today and low levels tomorrow.  Although when a woman is perimenopausal her hormone levels also change the blood tests are inconclusive as part of a diagnosis for menopause.

Because menopause is a natural occurance in woman and not a disease there is no actual treatment for menopause, but one can seek treatment for the menopausal symptoms.  These symptoms include hot flashes, mental stress disorder, depression, irregular menstrual cycles among others.  Hormones produced by the ovaries help control these symptoms from occurring in premenopausal woman but once you begin perimenopause the hormones are not produced as much.

Some woman who experience severe symptoms may lean towards hormone replacement drugs, hormone therapy.  Hormone therapy consists of the replacement of estrogen or a combination of estrogen and progesterone.  The hormones must be active to be effective.  This type of therapy is the best treatment for hot flashes and vaginal dryness.

Hormone therapy can be used in two forms, oral which is a pill, or transdermal which is applied to the body as in a spray or patch.   Oral hormone therapy must do a first pass before becoming active.  A first pass means that they must pass through the liver before becoming active.  Transdermal therapy is already active and doesn’t affect the liver.  Transdermal therapies are preferred for most patients using hormone therapy.  There is a variety of hormone therapies available and vary for each individual.

Studies of women using a combination of estrogen and progesterone hormone therapy long term had an increased risk in having a heart attack, stroke, and breast cancer.  When studies were done in woman using estrogen therapy alone the risk for heart attack and breast cancer declined but not for stroke.  Estrogen alone therapy also showed and increased risk of endometrial cancer in post menopausal woman.  These increased risks deterred some woman from using these conventional hormone therapies raising interest in bio- identical hormone therapies.

Bioidentical hormone products are the same hormones, that are made in the body, are made from natural plants in a laboratory.  The usage of these products is called bioidentical hormone therapy.  Natural plant products are altered in a lab to create the identical hormones made in the body.  The bioidentical hormone therapies are usually used in gel or cream form which makes them a transdermal therapy.  The FDA has approved some types of bioidentical hormone and these are being manufactured by some drug companies.  Some bioidentical hormone therapies are made on an individual case by case basis, however, these are not US – FDA approved and are manufactured by compound pharmacies.  There haven’t been any studies as to the effectiveness or adverse risks in long term usage of these bioidentical therapies but their advocates praise their results and like the fact they don’t carry the risks that the conventional therapies have.

Another therapy is oral contraceptives.  Yes, the pill.  Not only does it regulate the menstrual cycle, it relieves hot flashes, as well as, provides protection from the change of life pregnancy.

There is also local therapies for estrogen deficiency like the vaginal estrogen ring, or estrogen creams that can be applied vaginally.

Hormone therapies should be discussed with your doctor.  Each individual case is different and there are things needed to be considered like overall medical condition, medical history, as well as, risks involved and long term usage and benefits.  If hormone therapy is your plan of action it is recommended that its use be in the smallest dosage for the least amount of time.