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    Hormone Therapy for Menopause and Perimenopause

    If Your Sex Drive Is in a Dive

    This is tricky territory, says Dr. Richardson. Yes, libido generally wanes with age. “But how much of that is estrogen related, how much is linked to other hormones, and how much stems from aging nerve and connective tissues, life stresses, or relationship issues isn’t clear,” she says. Lack of sleep, changing body image, and painful sex due to vaginal dryness also dash desire.

    Will hormones help? In one small four-month study of healthy women between ages 45 and 55, HT boosted sexual thoughts and interest. But research has been mixed, and if a lack of estrogen isn’t the problem in your case, it’s unlikely to help. Try out a few quick fixes — lubricants, perhaps, or making some fantasies real (including the one where your partner does more housework). If these fail, talk to your doctor about specific issues and options.

    If Your Memory Is Shot

    Foggy brain? Fumbled words? Frantic hunts for cell phones and keys? “It takes a village to complete a thought,” says Kaye Denny, 53, who works alongside several women facing the same frustrations. The estrogen dips of menopause have been blamed for these cognitive challenges, but midlife brings other stresses — and often, an overloaded plate — that also mess with your mind.

    Will hormones help? A multicenter study recently showed that hormone therapy did nothing for memory. One exception: If your brain fog is the result of patchy sleep due to hot flashes and sweats, then HT might be part of the solution.

    If You Can’t Sleep

    Waking up repeatedly because of hot flashes and sweats leaves many women dragging the next day, not to mention irritable and forgetful. But temperature-control problems may not be the only cause: Some people simply start to have trouble falling asleep or staying asleep during these years, even if they’re not getting overheated or drenched.

    Will hormones help? HT does seem to help some women fall asleep faster, says Michelle P. Warren, M.D., medical director of the Center for Menopause, Hormonal Disorders and Women’s Health at Columbia University Medical Center. It may also help you stay asleep, Dr. Richardson says. But this research isn’t definitive. Upping daytime activity, dealing with stress, and practicing good sleep habits might do more to get you the rest you need. Lesley Bannatyne, 54, found exercising regularly helped cure her sleeplessness. “I had to make myself physically tired every single day,” she says. “When I started walking more and taking exercise classes, I really slept better.”

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