10 Questions to Ask Your Doctor About Hormone Therapy During Menopause

1. What is hormone replacement therapy?

The term "hormone replacement therapy" or HRT, refers to hormones such as estrogen, testosterone, and progesterone that are taken regularly to stabilize and increase a menopausal woman's hormone levels. It's good to know all the options that are available, from pills to patches, creams, and vaginal rings. Your doctor can explain them.

2. Why do some women need hormone replacement therapy during menopause?

Hormone therapy helps women whose menopausal symptoms -- hot flashes, night sweats, insomnia, mood swings, vaginal dryness -- are severe and affecting her quality of life. Are your symptoms serious enough to warrant taking hormones?

3. What else can I do to ease menopause symptoms?

There are many things you can do to curb hot flashes, night sweats, insomnia, vaginal dryness, and lost libido. Lifestyle changes -- such as regular exercise, a healthy diet, and relaxation techniques -- can help. If you smoke, quit (smokers tend to experience menopause earlier than nonsmokers). Lubricants can greatly ease vaginal dryness and heighten sexual sensation.

Your doctor can give you more information about these techniques and other treatment options. The use of selective serotonin reuptake inhibitors (SSRIs, a form of antidepressant) has become more common in women who are not good candidates for hormone therapy or prefer not to use hormones.

4. Do alternative remedies (like soy and black cohosh) help with menopause symptoms?

Studies into natural treatments for menopause symptoms have had mixed results. Some have shown that soy helps with hot flashes and night sweats but might be dangerous for women at risk for hormone-related cancers of the breast, ovaries and uterus. Black cohosh may help some women control hot flashes, night sweats, mood swings, and insomnia -- but again, research has been mixed, and some reports have linked black cohosh to liver problems.

Other natural remedies include chasteberry, red clover, dong quai, kava, and evening primrose oil. Your doctor can help you decide whether any alternative treatments are right for you.

5. Is it time for me to try hormone therapy?

Several factors play into whether hormone replacement therapy is the best option for you. Your age is one factor. Your doctor will also want to consider whether you’ve had a hysterectomy and whether you have certain health risks, such as a family or personal history of breast cancer or clotting disorders.

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6. What are the risks of hormone therapy?

Hormone therapy is not risk-free. In some women, hormone therapy can increase the risk of breast cancer, stroke, and blood clots. It’s important to weigh the risks against the benefits by talking to your doctor.

7. What are the benefits of hormone therapy?

The estrogen in hormone therapy can greatly relieve menopause symptoms such as hot flashes and vaginal dryness. It can also lower a woman’s risk of colon cancer and macular degeneration (vision loss that occurs with age), and help protect bone strength.

8. How long will I have to take hormone replacement therapy?

Most women take hormone therapy for the shortest time possible -- and at the lowest dose. There is evidence that serious health risks such as blood clots, breast cancer, and stroke increase after five years of use. If you have personal or family history of these and other health risks, this will affect your decision regarding hormone replacement therapy.

9. Will hot flashes and other menopausal symptoms return when I quit hormone therapy?

Your symptoms may return slightly when you stop taking hormones, but they will likely taper off over several months to a year. Your doctor can help you manage these symptoms. For some they may be lifelong.

10. Are there other things I can do to protect myself against osteoporosis?

Doctors have long known that estrogen therapy helps prevent osteoporosis (but hormones should not be given just to prevent or treat osteoporosis). There are many other ways to protect your bone health. Regular weight-bearing exercise and a diet high in calcium and vitamin D strengthen bones. There are also many bone-building medications available to women today. Your doctor can help you decide the best bone health strategy for you.

WebMD Medical Reference Reviewed by Nivin Todd, MD on July 24, 2016

Sources

SOURCES:

National Institutes of Health.

WebMD Medical Reference From Healthwise: “Should I use hormone replacement therapy (HRT)?”

WebMD Medical Reference provided in collaboration with the Cleveland Clinic: “Is Hormone Replacement Therapy Right for You?”

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