Menopause and Hormones

 


What is Menopause?

Menopause is a normal change in a woman’s life when her period stops.  That’s why some people call menopause “the change of life” or “the change.”  During menopause a woman’s body slowly produces less of the hormones estrogen and progesterone.  This often happens between the ages of 45 and 55 years old.  A woman has reached menopause when she has not had a period for 12 months in a row.

What is Hormone Therapy for Menopause?

Hormone therapy for menopause has also been called hormone replacement therapy (HRT).  Lower hormone levels in menopause may lead to hot flashes, vaginal dryness and thin bones. To help with these problems, women are often given estrogen or estrogen with progestin (another hormone).  Like all medicines, hormone therapy has risks and benefits.  Talk to your doctor, nurse, or pharmacist about hormones.  If you decide to use hormones, use them at the lowest dose that helps.  Also use them for the shortest time that you need them. (For example, check every 3-6 months to see if you still need them).

What are the Symptoms of Menopause?

Every woman’s period will stop at menopause.  Some women may not have any other symptoms at all. As you near menopause, you may have:

  • Changes in your period-time between periods or flow may be different.
  • Hot flashes (“hot flushes”)-getting warm in the face, neck and chest.
  • Night sweats and sleeping problems that may lead to feeling tired, stressed or tense.
  • Vaginal changes-the vagina may become dry and thin, and sex may be painful.
  • Thinning of your bones, which may lead to loss of height and bone breaks (osteoporosis).

What are the Benefits of Using Hormones for Menopause?

  • Hormone therapy is the most effective FDA approved medicine for relief of hot flashes, night sweats or vaginal dryness.
  • Hormones may reduce your chances of getting thin, weak bones (osteoporosis) which break easily.

What are the Risks of Using Hormones for Menopause?

Hormone therapy increases women’s chances of getting blood clots, heart attacks, strokes, breast cancer, and gall bladder disease.  Hormone therapy increases the chances of developing breast cancer for all women, and especially for women who were previously diagnosed and treated for breast cancer.1 For a woman with a uterus, estrogen increases her chance of getting endometrial cancer (cancer of the uterine lining). (Adding progestin lowers the risk of endometrial cancer).

To learn more about the debate about hormone therapy for menopause, click here.

Should I Use Estrogen Just to Prevent Thin Bones?

There are also other medicines and things you can do to help your bones.

Will Hormone Therapy Protect the Heart, Prevent Strokes, or Prevent Memory Loss or Alzheimer’s Disease?

No.

Do Hormones Protect Against Aging and Wrinkles or Increase My Sex Drive?

There is no evidence that hormone therapy prevents aging and wrinkles or increases sex drive.

Does It Make a Difference What Forms of Hormones I Use for Menopause?

The risks and benefits may be the same for all hormone products for menopause, such as pills, patches, vaginal creams, gels, rings, or “custom-mixed (compounded) hormones” prepared by a pharmacist. However, a 2018 review has shown that estrogen-progesterone therapy is associated with a higher risk of coronary heart disease and breast cancer than estrogen therapy alone.2

Are So-Called “Bioidentical Hormones” Safer or More Effective Than Other Forms of Hormone Therapy for Menopause?

The FDA does not have evidence that “bioidentical hormones” are safer or more effective than other hormone products. FDA believes that the benefits and risks are likely to be the same.

Is The Hormone Estriol a “Safer Form of Estrogen”?

The FDA has not approved any drug that contains estriol. FDA does not have evidence that estriol is safe or effective.

Learn more information here.

All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.

The National Center for Health Research is a nonprofit, nonpartisan research, education and advocacy organization that analyzes and explains the latest medical research and speaks out on policies and programs. We do not accept funding from pharmaceutical companies or medical device manufacturers. Find out how you can support us here.

References

  1. Poggio F, Del Mastro L, Bruzzone M, Ceppi M, Razeti MG, Fregatti P, Ruelle T, Pronzato P, Massarotti C, Franzoi MA, Lambertini M. Safety of systemic hormone replacement therapy in breast cancer survivors: a systematic review and meta-analysis. Breast Cancer Research and Treatment. 2021:1-7.
  2. Martin KA, Barbieri RL, Synder PJ, Crowley WF. Menopausal hormone therapy: Benefits and risks. Up To Date. April 2017.