Dr. Emily Stone, a Menopause Society Certified Practitioner, weighs the benefits and risks of menopause hormone therapy.
Summary: Formerly referred to as Hormone Replacement Therapy (HRT), Menopause Hormone Therapy (MHT) offers relief for symptoms of menopause like hot flashes, night sweats, and vaginal dryness, while also providing benefits such as prevention of osteoporosis and bone fractures. It also has the potential to help with other menopause-related symptoms, such as muscle and joint aches and pains, mood changes including anxiety and depression, sleep issues, and decreased libido. While not ideal for everyone, MHT can be life-changing for the right candidates. Consult a doctor to explore your options.
Have you been experiencing symptoms associated with perimenopause or menopause? Hot flashes, night sweats, vaginal dryness, mood changes, sleep disruption, and low libido do not need to be your reality. For so many women, the benefits of menopause hormone therapy (MHT), formerly referred to as hormone replacement therapy (HRT), make symptoms manageable and life more comfortable.
While MHT is not ideal for every woman, for some, it can be life-changing. In this blog, we’ll share a few of the major benefits of MHT for women who are experiencing the hormone fluctuations related to perimenopause and the menopause transition, or the decrease in hormones related to menopause. Continue reading to learn how the appropriate treatment helps some women feel like themselves again.
What Is Menopause Hormone Therapy (MHT)?
When you’re young and healthy, your hormones act as your body’s high-speed courier system. Their role is to deliver messages from one system of your body to another.
For example, because of hormones, your pancreas knows to release insulin after a big meal. Your hormonal messengers then transport the resulting glucose to your cells. In that example, the result is energy, which fights fatigue and keeps you moving.
During perimenopause and menopause, the number of “chemical couriers” in your body begins to change. Perimenopause is notable for big hormonal fluctuations or swings. Menopause is notable for decreased estrogen and progesterone production. The symptoms noted above are the result of these hormone changes.
For example, estrogen and progesterone hormones play a role in temperature regulation throughout the body. That’s why some women experience hot flashes and night sweats before and during menopause. It is the reduction in hormone volume that causes the symptoms.
In essence, Menopause Hormone Therapy (MHT), which was formerly known as Hormone Replacement Therapy (HRT), is a way to outsource the work of your body’s courier system and treat your symptoms. You supplement your diminished estrogen and progesterone to relieve the uncomfortable symptoms of perimenopause and menopause.
The estrogen component of MHT has numerous routes for administration:
- Patches
- Gels
- Vaginal rings
- Sprays
- Pills
The progestin component (for those with a uterus, to provide endometrial protection) also has numerous routes for administration:
- Oral
- Patch (in combination with estrogen)
- Intrauterine device
The potential MHT benefits for perimenopausal and menopausal women are numerous. We also understand that some women have reservations. Some of the most common concerns about this treatment are addressed below.
Is Menopause Hormone Therapy Safe?
Hormone therapy for menopause, which has been in use for over 60 sixty years, is becoming even more popular today as education about MHT increases. Like all medications, MHT comes with some risks and side effects. However, evidence says that the risks of serious side effects are very low. For most women, the benefits of MHT usually outweigh the risks. For some, though, the risks can make taking the medications less safe.
Menopause hormone therapy is not likely safe for:
- Women who have or have had ovarian, breast, or uterine cancers
- Women who are at high risk for blood clots or have experienced blood clots
- Women with a history or increased risk of cardiovascular disease
- Pregnant women
- Women with certain gallbladder or liver conditions
Before prescribing MHT, your doctor will discuss your goals and your medical history (including potential contraindications as noted above) and advise you of the risks and benefits.
In some cases, your doctor may decide that MHT is not the right treatment for your case. If so, you may wish to explore other treatment options. There are several non-hormonal medications designed to treat hot flashes and night sweats.
However, be aware that many of the risks of MHT are associated with older studies. Today, doctors know more about how to identify the ideal candidates for this treatment.
Most physicians agree that for women who begin MHT within 10 years of menopause and are under 60 years old (otherwise known as the “timing hypothesis”), the benefits outweigh potential risks.
Benefits of Menopause Hormone Therapy
What are the benefits of menopause hormone therapy? There are many – ranging from relief from bothersome symptoms to potentially reducing the risk of certain health issues.
The following are the most common benefits of MHT.
1. Reduction of Hot Flashes and Night Sweats
For most older women, the greatest benefit of menopause hormone therapy is symptom reduction, especially of hot flashes and night sweats. MHT is the gold standard for treatment of these symptoms. You may also notice improvement in your quality of sleep and mood changes, including anxiety and depression.
With that said, menopause hormone therapy comes with other potential benefits as well.
2. Prevention of Osteoporosis
Estrogen contributes to the maintenance of strong bones by preventing bone loss. As estrogen levels drop, your bones can become weaker and more brittle. One of the benefits of the estrogen component in MHT is a reduced risk of osteoporosis and fractures in menopausal women.
3. Reduction in Muscle and Joint Aches and Pains
Fluctuating and then declining estrogen levels can lead to increased muscle and joint aches and pains. Menopause hormone therapy may help with these symptoms.
4. Improved Libido
MHT can address symptoms of menopause associated with low libido secondary to discomfort during intercourse. For example, estrogen in MHT can improve vaginal dryness that can cause chafing and discomfort during penetration. In some women, MHT can even improve arousal. Ultimately, choosing MHT may enhance sexual pleasure and improve your quality of life.
How Long Does Menopause Hormone Therapy Take to Work?
Many women see an improvement of their symptoms within weeks, if not days, of beginning MHT; but it may take a full 2-3 months to experience all the benefits of a new treatment or dose. The timing depends on factors like the type of hormone therapy used as well as how an individual’s body reacts to it. You and your doctor may also need to do some fine-tuning to find the right dose, and each adjustment will require some time before you can evaluate whether it’s working.
Manage Menopause Symptoms with VPFW
For some women who are candidates for menopause hormone therapy, the relief it provides can be life-changing. Others may decide they don’t need any treatment to manage their menopause symptoms. Every woman is different, and your doctor can help you decide whether to try MHT or other menopause treatment options. If you choose to begin MHT, your provider will work with you to find a dose and treatment plan that meets your needs.
Are you wondering if you’re a candidate for menopause hormone therapy? Schedule an appointment and get a personalized evaluation of the benefits and risks of menopause hormone therapy today!
Check out some of Dr. Stone’s favorite menopause resources:
- “Should We All Be on Hormone Therapy?” with Professor Susan Davis, AO, Hit Play Not Pause Podcast, Episode 187
- The Menopause Society’s MenoNotes, written by menopause experts to provide clear, easy-to-understand explanations of important menopause-related topics
- “Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long?” American Heart Association Journals, Circulation (journal) Feb 2023 (free access online)
