Is Hormone Replacement Therapy Right for Me?
2. What's Your Health History?
If you have a history of any these conditions, HRT probably isn’t right for you:
- Breast, ovarian, or endometrial cancer
- Blood clots (particularly in your lungs or legs)
- Heart problems
If you smoke, you can’t use HRT. You’ll have a much higher risk of blood clots and other health problems.
3. How Severe Are Your Symptoms?
If you have few or no menopause symptoms, there’s no need to take HRT. “But if you’re uncomfortable, you may want to consider it,” says Mary Jane Minkin, MD, clinical professor in obstetrics, gynecology and reproductive sciences at Yale Medical School.
Along with easing hot flashes, HRT can relieve vaginal dryness too. It also helps some women sleep better and improves their mood. “You should have substantial relief by 4 weeks,” Minkin says. “If you don’t see improvement in 12 weeks, you’ll need to try higher doses.”
Most experts recommend using HRT for no more than 5 years. The longer you use it, the higher the risks.
4. What Else Have You Tried?
“Many women try other remedies before HRT,” Minkin says.
Over-the-counter lubricants treat vaginal dryness, which can make sex painful. Certain antidepressants called SSRIs can help with mood, but they can also cause weight gain and dampen libido. Exercise and good sleep habits can help with symptoms like low mood, insomnia, and weight gain.
“Cognitive behavioral therapy and hypnosis have been shown to be effective for menopause symptoms,” Pinkerton says. But studies show that no supplement works better than placebo, a pill or treatment that doesn’t actually contain medicine.
You may hear a lot about "bioidentical hormone treatments." Not all are FDA-approved. The agency hasn’t given the nod to compounded bioidenticals, which are made by a pharmacist, because doses can vary. (Traditional HRT is FDA-approved.)
“Women have been so afraid to use hormone therapy that they have used unproven or untested supplements, or compounded hormone therapies, which are not FDA regulated or monitored,” Pinkerton says. “The hormones they contain aren’t tested or monitored for safety. You may be getting too little or too much medication.”