Hormone therapy can help relieve the symptoms of menopause. It can replace female hormones no longer made by the ovaries. In some cases, you may begin hormone therapy before menopause. If you are taking birth control pills, they will be stopped when you begin treatment.

For women with a uterus, estrogen usually is given along with progestin. This helps reduce the risk of cancer of the lining of the uterus that occurs when estrogen is used alone. The progestin may be taken every day with estrogen, or estrogen may be taken on some days and the progestin added on others.

Hormone treatment is most often prescribed in the form of pills, vaginal rings or patches placed on the skin. Estrogen creams and tablets, used in the vagina, can treat dryness, but do not work as well for other symptoms.

Benefits

Estrogen is used to treat the main symptom of menopause—hot flashes. It also relieves vaginal dryness and can help to relieve some changes that can cause problems in the urinary tract. Estrogen protects against bone loss. Hormone therapy slows bone loss after menopause and helps prevent osteoporosis. Estrogen also can help reduce the risk of colon cancer.

Risks

Like any treatment, hormone therapy is not free of risk. If you have a uterus, using estrogen alone can increase the risk of endometrial cancer. That is because estrogen causes the lining of the uterus to grow. Taking a progestin along with estrogen will help reduce the risk of uterine problems. The drawback of using a progestin is that it seems to increase the risk of breast cancer. Also, menopausal women may start bleeding again. Although bleeding may occur only for a short time, many women find this bleeding bothersome.

The Women's Health Initiative, a study by the National Institutes of Health, raised concerns about the risks of hormones for postmenopausal women. Because of these findings, the U.S. Food and Drug Administration (FDA) announced that all products for use by postmenopausal women that contain estrogen should include a warning label. The label states that prolonged use of these hormones could increase the risk of heart attacks, strokes, blood clots and breast cancer for some women. The study results suggest that the increased risk of health problems from hormone therapy may vary from woman to woman depending on how far a woman is past menopause. For example, a woman who is 15 years past menopause may be at greater risk than a woman who is 2 years past menopause. You should take the smallest dose of hormone therapy that works for you, for the shortest amount of time. You and your doctor should decide whether this treatment is right for you.

See also:

• ObGyn care for midlife and menopause
• Alternatives to hysterecomy
• Midwifery