Hormone Therapy for Menopause and Perimenopause
If You Have Hot Flashes and Sweats continued...
Will hormones help? Lifestyle changes may help you cool off
sufficiently. But if not, hormone therapy (HT) does ease hot flashes and
sweats. Indeed, that’s one of the three FDA-approved uses of HT (the others are
treatment of vaginal dryness and osteoporosis prevention). For some women, like
Tricia Droney, 52, who was having up to 40 hot flashes a day, HT is the most
reliable remedy. You’ll need the kind that works systemically — pills (many
brands, including Prempro, Femhrt), patches (Vivelle-Dot, CombiPatch), gel
(Divigel, EstroGel), spray (Evamist), lotion (Estrasorb), or one type of
vaginal ring (Femring).
Unless you’ve had a hysterectomy, it’s standard for doctors to prescribe
estrogen combined with progestin to block overgrowth of your uterine lining
(which can lead to endometrial cancer). Combination therapies can be continuous
(both hormones daily) or cyclic (typically, progestin added 10 to 14 days a
month). Medically speaking, none of these regimens has clear benefits over the
If You Have Vaginal Dryness
As you enter menopause, vaginal walls thin and become drier. This is one
symptom that doesn’t settle down with time — if anything, it can grow worse.
Sex may be painful, and you may become more prone to urinary tract infections
because the urethra, which carries urine from the bladder, is more easily
Will hormones help? Estrogen works well to rejuvenate and
lubricate vaginal walls. Unless you’re also having bad hot flashes, both the
FDA and the North American Menopause Society advise that you try a product that
you apply locally (but not Femring, which is a systemic product). Since minimal
estrogen spills into the bloodstream, these products are a better option if you
have health issues that rule out pills or patches. Choices include a vaginal
ring worn for three months (Estring), cream (Estrace), or suppositories
(Vagifem). You may also want to try hormone-free personal moisturizers (such as
Replens), which you apply twice weekly, and in-the-moment lubricants (such as
Astroglide and K-Y Silk-E) before or during sex.