Frequently Asked Questions About Menopause

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Wednesday, 20 February 2008

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Frequently Asked Questions About Menopause
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8. Is HT Safe?

As with all medicines, there are risks and benefits. Results from a large study, the Women's Health Initiative, showed that long term use of estrogen-progesterone combination therapy caused an increased risk of breast cancer, heart disease, blood clots and stroke. Estrogen alone did not increase breast cancer or heart disease, but the study also found that therapy with estrogen alone increases the risk of blood clots and stroke.

Although the WHI study found an increase in the risk of heart disease in women taking combination HT, more recent studies suggest this finding may not be relevant to all postmenopausal women.

One of these newer studies, published in the January/February 2006 issue of The Journal of Women's Health, showed the risk of heart disease demonstrated in the WHI may be related more to the advanced age of the participants as opposed to the HT itself.

Another study, published in the February 13, 2006 issue of the Archives of Internal Medicine, looked at nearly 11,000 women aged 50 to 79 taking only estrogen. (Women who have not had a hysterectomy must take progesterone along with estrogen to reduce the risk of uterine cancer.) Researchers reported no overall difference in heart attack risk among women who took the hormone and those who did not. In addition, there appeared to be a lower overall risk of heart disease in the women who began taking the estrogen between the ages of 50 and 59, suggesting a heart-healthy benefit to taking the therapy, if begun at a younger age.

More studies are underway to investigate the relationship between HT and heart disease.

If you are concerned about taking HT, talk to your doctor; there are other options.

9. What Alternative Treatments Are Available?

Botanical products containing or acting like estrogens may provide some of the benefits of estrogen in relieving menopausal symptoms, but are not as well studied. Other botanicals, including black cohosh, have also shown promise for reducing menopausal sweats, or hot flashes. However, more research is needed to define the benefits and risks of these alternative treatments, and you should always check with your doctor before using them. Only HT is FDA-approved to treat menopausal symptoms.

10. Sex Has Become Painful. What Can I Do to Make It More Enjoyable?

The pain you are experiencing during sex is likely due to vaginal dryness associated with declining estrogen levels. There are a number of lubricants you can try. Ask your doctor or pharmacist for a suggestion. There are local estrogen treatments-cream, tablets, and an estrogen ring-for women desiring treatment of vaginal atrophy.

Reviewed by Holly L. Thacker, M.D., F.A.C.P., Director of The Women's Health Center at The Cleveland Clinic, January 2006.

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SOURCES: The Women's Health Center at The Cleveland Clinic. VitaDocs Medical Reference provided in collaboration with The Cleveland Clinic: "Hot Flashes." VitaDocs Medical Reference provided in collaboration with The Cleveland Clinic: "Is Hormone Therapy Helpful at All?” The National Institutes of Health: Women’s Health Institute. The Women’s Health Journal Jan/Feb 2006.