Hormone therapy is an option to treat menopause

As a menopause practitioner, I get this question frequently from women who have already gone through menopause without hormonal support. Questions like, “Is it too late?” or “Do I have to feel like this for the rest of my life?” are very common. Menopause is having a “moment” in national news, social media and research. Women are being bombarded with new information that brings questions like these to light. The answers are complex, but my goal is always to treat each patient as an individual to find the right treatment for her. 

Hormone therapy (HT) has several well-recognized health benefits, including prevention of osteoporosis

and colon cancer. It also helps women manage debilitating symptoms like hot flashes, night sweats, insomnia, depression, anxiety and vaginal symptoms. There are, however, some risks associated with HT, such as an increased risk of breast cancer or negative cardiovascular effects. How those benefits and risks play out depends on each patient’s health history. In general, the most long-term health benefit is for women who start HT prior to menopause, but that doesn’t necessarily mean that women beyond that point can’t benefit as well. 

A personalized approach that takes each woman’s current health status into account is critical. For example, at age 60, many women are still very healthy and can safely take HT if there are symptoms that require treatment. As women age, however, they often begin to increase their risk factors for cardiovascular disease with the diagnosis of conditions like high blood pressure, elevated cholesterol, diabetes or heart disease. For these patients, we need to carefully consider whether the benefit of treating the symptoms of menopause outweighs any additional risk to their health that HT may cause. This is when a conversation with a knowledgeable menopause practitioner is crucial. 

I try to make a decision together with my patient about how to proceed, based on a careful and evidence-based risk assessment. After we begin HT, I closely monitor her health status and any new diagnosis that could add risk. Then, we start a shared decision-making process as to when or if HT should be discontinued. There is no evidence to support an age-based “hard stop” on HT. 

Women do not have to suffer through menopause; it can be a wonderful phase of life if managed properly and safely. Finding a knowledgeable practitioner to guide you through this time is the key, and I find that part of my practice to be highly rewarding.

To learn more about menopausal women’s health or find a provider near you, visit our website.