Will Hormone Therapy Help Prevent Long
The benefits and risks of hormone therapy vary depending on a womans age and her individual history. In general, younger people in their 50s tend to get more benefits from hormone therapy as compared to those who are postmenopausal in their 60s. People who undergo premature menopause are often treated with hormone therapy until age 50 to avoid the increased risk that comes from the extra years of estrogen loss.
Taking Estrogen With A Progestin Vs Estrogen Alone
Treating menopausal symptoms with estrogen and progestin together is known as estrogen-progestin therapy or combined hormone therapy. Although estrogen alone improves the symptoms of menopause, it increases the risk of cancer of the uterus . Adding a progestin to the estrogen lowers the risk of endometrial cancer back to normal. Because of this, EPT is given to women who still have a uterus . EPT can be given 2 ways:
- Continuous EPT means the same dose of estrogen and progestin is taken each day. Women often prefer continuous EPT because it rarely leads to menstrual-like bleeding.
- Sequential EPT means different amounts of each hormone are taken on specific days. There are different ways to do this. For example, estrogen can be taken by itself for 14 days, then estrogen plus progestin for 11 days, then neither hormone for 3 to 5 days. Other schedules involve taking progestin only every few months. This lowers the amount of progestin that you are exposed to. Monthly regimens are also thought to result in hormone levels that are more like the natural menstrual cycle. Cyclical EPT can produce bleeding like a menstrual period, but it can occur less often than monthly.
General Recommendations For Ht
Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:
- HT may be started in women who have recently entered menopause.
- HT should not be used in women who have started menopause many years ago.
- Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
- Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
- HT should be used only for menopause symptom management, not for chronic disease prevention.
Initiating Therapy
Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:
- Heart disease
- Osteoporosis
- Breast cancer
While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.
Discontinuing Therapy
Safety Concerns
Women who should not take hormone therapy include those with the following conditions:
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What Can I Do About Hot Flashes
Hot flashes occur from a decrease in estrogen levels. In response to this, your glands release higher amounts of other hormones that affect the brain’s thermostat, causing your body temperature to fluctuate. Hormone therapy has been shown to relieve some of the discomfort of hot flashes for many women. However, the decision to start using these hormones should be made only after you and your healthcare provider have evaluated your risk versus benefit ratio.
To learn more about women’s health, and specifically hormone therapy, the National Heart, Lung, and Blood Institute of the National Institutes of Health launched the Women’s Health Initiative in 1991. The hormone trial had 2 studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. Both studies ended early when the research showed that hormone therapy did not help prevent heart disease and it increased risk for some medical problems. Follow-up studies found an increased risk of heart disease in women who took estrogen-plus-progestin therapy, especially those who started hormone therapy more than 10 years after menopause.
The WHI recommends that women follow the FDA advice on hormone therapy. It states that hormone therapy should not be taken to prevent heart disease.
Practical suggestions for coping with hot flashes include:
Menopause: The End Of Your Menstrual Cycle
Menopause refers to a specific point in time when your periods stop. Youre only in the menopause phase for one year, because when youve gone 12 consecutive months without a period, you enter post-menopause.
Reaching menopause means that youre no longer able to bear children . Every woman except for those whove had their ovaries removed before puberty will go through menopause.
At what age does menopause start?
The average age for menopause is around 51. But some women experience menopause in their 40s with a small percentage experiencing signs of menopause earlier. Some women may not reach menopause until their 60s.
Theres no way to know your exact menopause age until it happens, but genetics seems to play a strong role. You may get a general idea of when to expect menopause based on when your family members went through it, particularly your mother.
Genetics isnt the only thing that can impact when menopause starts. Medical factors can also influence menopause timing. For example, if someones ovaries are removed, symptoms will begin to show immediately.
Certain medical conditions like autoimmune diseases have also been associated with early menopause. Women whove undergone treatments like radiation therapy or chemotherapy are also more likely to show symptoms earlier.
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When Does Menopause Begin
Menopausal symptoms usually start from around age 47 years. The final menstrual period is usually about age 51 but can vary considerably. There is currently no reliable way to predict when you will experience menopause and what your menopausal symptoms will be like.
When menopause happens before 40 years it is called premature, and when it happens before 45 years it is called early. Menopause after age 45 years is considered normal and there is no upper age limit to when it can begin. However, most women have experienced menopause by age 55 years.
Estrogen And Weight Gain
Estrogens responsible for increasing fat storage at the hips and thighs, providing the hour-glass shape. Progesterone, when working in unison with Estrogen, normally halts the storage of fat around the waist, but factors can come into play that interfere with this harmonious partnership.
Stress can have a negative impact on progesterones action. It leads to weight gain around the belly that is very difficult to shift due to your progesterone levels being significantly lower than your Estrogen levels.
High levels of stress have been shown to negatively impact progesterone. Therefore, if you find fat accumulating around your waist, you may want to work at reducing any stress in your life and help keep progesterone levels in check.
Since Estrogen levels decline in a womans later years, which leads to the negative effects associated with menopause such as hot flushes and night sweats many of my clients think that, surely, having an excess of Estrogen is a good thing.
Unfortunately, this is not the case. If you would like to know more about the delicate balance of Estrogen and progesterone here is a good article.
When you are Estrogen dominant, the positive effects that progesterone has on the body are blocked. This happens because Estrogen overstimulates both the brain and the body.
Effects such as calmness and easing fluid retention are the two major, wonderful benefits of progesterone that are sadly missed by any Estrogen dominant, high-strung, bloated, stressed woman.
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How Does Menopause Affect My Bone Health
The decline in estrogen production can affect the amount of calcium in your bones. This can cause significant decreases in bone density, leading to a condition known as osteoporosis. It can also make you more susceptible to hip, spine, and other bone fractures. Many women experience accelerated bone loss the first few years after their last menstrual period.
To keep your bones healthy:
- Eat foods with lots of calcium, such as dairy products or dark leafy greens.
- Take vitamin D supplements.
- Exercise regularly and include weight training in your exercise routine.
- Reduce alcohol consumption.
- Avoid smoking.
There are prescription medications you may want to discuss with your doctor to prevent bone loss as well.
What Hormones Are Used To Treat The Symptoms Of Menopause
The hormones most commonly used to treat symptoms of menopause are estrogen and progesterone. . Often, these 2 hormones are used together, but some women are given estrogen alone. Its important to know which hormones you are talking about when looking at the risks.
Common estrogen preparations used to treat menopausal symptoms include conjugated equine estrogens and estradiol, but several forms or types of estrogen are available.
There are also many progestins available, but medroxyprogesterone acetate , is often used with an estrogen to treat menopausal symptoms. Some preparations contain both an estrogen and a progestin.
Androgens are also sometimes used to treat menopausal symptoms. This is not common, though, and because only a few studies have looked at this practice, it isnt clear how safe it is in the long run.
Tibolone is a synthetic hormone drug that can act like estrogen, progesterone, and testosterone in different tissues of the body. Because this drug isnt available in the US, its not discussed here.
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Do Men Go Through Menopause
Andropause, or male menopause, is a term given to describe decreasing testosterone levels in men. Testosterone production in men declines much more gradually than estrogen production in women at about 1% per year. Healthcare providers often debate calling this slow decline in testosterone menopause since its not as drastic of a hormone shift and doesn’t carry the same intensity of side effects as menopause in women. Some men will not even notice the change because it happens over many years or decades. Other names for the male version of menopause are age-related low testosterone, male hypogonadism or androgen deficiency.
Will I Gain Weight When I Experience Menopause
Changes in your hormone levels may cause you to gain weight. However, aging can also contribute to weight gain.
Focus on maintaining a balanced diet, exercising regularly, and practicing other healthy habits to help control your weight. Being overweight can increase your risk for heart disease, diabetes, and other conditions.
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Ht Forms And Regimens
HT comes in several forms:
- Oral tablets or pills
- Vaginal ring
- Topical gel or spray
HT pills and skin patches are considered “systemic” therapy because the medication delivered affects the entire body. The risk for blood clots, heart attacks, and certain types of cancers is higher with hormone pills than with skin patches or other transdermal forms.
Vaginal forms of HT are called “local” therapy. Doctors generally prescribe vaginal applications of low-dose estrogen therapy to specifically treat menopausal symptoms such as vaginal dryness and pain during sex. This type of ET is available in a cream, tablet, or ring that is inserted into the vagina.
“Bioidentical” Hormones
“Bioidentical” hormone therapy is promoted as a supposedly more natural and safer alternative to commercial prescription hormones. Bioidentical hormones are typically compounded in a pharmacy. Some compounding pharmacies claim that they can customize these formulations based on saliva tests that show a woman’s individual hormone levels.
The FDA and many professional medical associations warn patients that “bioidentical” is a marketing term that has no scientific validity. Formulations sold in these pharmacies have not undergone FDA regulatory scrutiny. Some of these compounds contain estriol, a weak form of estrogen, which has not been approved by the FDA for use in any drug. In addition, saliva tests do not give accurate or realistic results, as a woman’s hormone levels fluctuate throughout the day.
What Are The Long
There are several conditions that you could be at a higher risk of after menopause. Your risk for any condition depends on many things like your family history, your health before menopause and lifestyle factors . Two conditions that affect your health after menopause are osteoporosis and coronary artery disease.
Osteoporosis
Osteoporosis, a “brittle-bone” disease, occurs when the inside of bones become less dense, making them more fragile and likely to fracture. Estrogen plays an important role in preserving bone mass. Estrogen signals cells in the bones to stop breaking down.
People lose an average of 25% of their bone mass from the time of menopause to age 60. This is largely because of the loss of estrogen. Over time, this loss of bone can lead to bone fractures. Your healthcare provider may want to test the strength of your bones over time. Bone mineral density testing, also called bone densitometry, is a quick way to see how much calcium you have in certain parts of your bones. The test is used to detectosteoporosis and osteopenia. Osteopenia is a disease where bone density is decreased and this can be a precursor to later osteoporosis.
If you have osteoporosis or osteopenia, your treatment options could include estrogen therapy.
Coronary artery disease
- The loss of estrogen .
- Increased blood pressure.
- A decrease in physical activity.
- Bad habits from your past catching up with you .
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How Can You Know If Your Hormones Are Out Of Whack
One of the easiest ways to know if your own hormones are out of whack or imbalanced is to consider your daily symptoms. Think back to how you used to feel. It may be difficult to notice some changes if they have sneaked up on you. However, write down anything that bothers you most days of the week. Just because you know other women of your age who deal with the same daily symptoms does not mean that these feelings are normal. Some of the most common physical symptoms of hormonal imbalance include the following:
- Hot flashes
- Mood swings
- Poor memory
If your symptoms are alerting you to a possible problem, you should definitely ask your doctor about a hormone balance test. This is usually a simple blood test that will let your doctor see the levels of a variety of hormones in your bloodstream during different times of the day. Because hormonal balance is incredibly complex, your doctor may recommend that you undergo several different blood tests over a longer period to monitor how your levels may be changing throughout the month especially if you have not yet completed menopause.
Will I Still Enjoy Sex After Menopause
You should still be able to enjoy sex after menopause. Sometimes, decreased sex drive is related to discomfort and painful intercourse. After treating the source of this pain , many people enjoy intimacy again. Hormone therapy can also help many people. If you are having difficulties enjoying sex after menopause, talk to your healthcare provider.
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Why Is Hypothyroidism So Often Missed In Women Over 50
While there are a few reasons for this, my vast experience points to these two reasons as the primary ones.
First. The symptoms of hypothyroidism and menopause are similar. Its quite common that around the age of 45 to 50, many women begin reporting to their doctors that they are suffering with depression, fatigue, brain fog, struggles with weight gain, and low libido. If youre at all like these women, youre hoping for answers, solutions, and R.E.L.I.E.F. Nearly every day in my practice I hear from women, saying that their doctors commonly attribute these issues to menopause or normal aging. Google these signs and symptoms and youll probably find the same conclusions drawn.
Do You Know the Signs of Low Thyroid Function?
- Fatigue, feeling exhausted all the time, requiring more than 8 hours of sleep, having to take a nap every day
- Unexplained weight gain, difficulty losing weight, or maintaining your ideal weight
- Depressed mood, unmotivated, lost your Mojo
- Impaired memory, Brain Fog
- Loss of Libido
- Feeling cold all the time, especially hands and feet
Note that most of these signs and symptoms are also commonly associated with menopause.
Second. Lab Testing. And this problem is actually two-fold:
Part 2 of this series will cover the 6 components I recommend, and Ill be explaining the concept of functional ranges.
Eat Plenty Of Fruits And Vegetables
Eat 7 servings of fresh, organic vegetables and fruits each day. I like my patients to get 4 to 5 vegetables and 2 to 3 fruits. The cruciferous vegetables are especially good for balancing estrogen levels. Carrots, beets, and other root vegetables can assist in removing any excessive levels of estrogen from your body. Avocado, a fruit, is excellent at reducing the stress hormone cortisol and reducing any excessive estrogen present while increasing progesterone levels.
The best way to ensure that you not eating GMO fruit is to grow it yourself!
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Natural Solutions For Dryness
At menopause, vaginal blood flow falls. Dryness and irritation can occur, and bacteria infections that pass to the urinary tract are more likely.
What is to be done? First of all, even after the ovaries stop, the adrenal glands and the fat tissue continue to contribute to estrogen production after menopause. In addition, phytoestrogens in plants provide weak estrogen effects. Soy products, such as tofu, tempeh, and miso, contain huge amounts of these natural compounds.
The plant-derived estrogen and progesterone creams described above can be helpful. Used on a regular basis, these creams maintain a moist vaginal lining. However, please note that they should not be used as a sexual lubricant. Estrogen cream is a medication, not a lubricant, and it goes through any skin it touches, including mens. Many women prefer to avoid hormone creams entirely and use ordinary lubricants or moisturizers instead.