Menopause and Perimenopause - Medications
Estrogen replacement therapy (ERT) is used to prevent
weakening bones and the severe symptoms that come with sudden, early menopause.
Early menopause usually happens after surgery to remove the uterus and ovaries
(hysterectomy and oophorectomy) or from ovary failure
after cancer treatment. But ERT is known to slightly increase the risks of
stroke and blood clots during the first year of use.16
Long-term ERT may slightly increase breast and ovarian cancer risks.17, 12
Taking estrogen by
itself (ERT) can lead to
uterine (endometrial) cancer. Taking progestin with
estrogen protects against uterine cancer. This is why ERT is only recommended
if you have no uterus. If you have not had your uterus removed and want hormone
therapy, you take progestin with the estrogen (HRT).
- Hysterectomy and Oophorectomy: Should I Use Estrogen Replacement Therapy (ERT)?
Short-term, low-dose HRT or ERT is hoped to offer a balance between HRT benefits and risks. It can
be taken for up to 4 to 5 years, with regular checkups. This may work well for
many women, who will find that their menopause symptoms have subsided within
this period of time. As more women use low-dose hormones for shorter periods of
time after menopause, researchers will be able to learn about the actual
benefits and risks.
progesterone creams (available in health food stores
or through mail order) or prescription
progestin creams, which are made by a compounding
pharmacist, are marketed to correct low
progesterone levels. While some women report finding
relief with progesterone cream, many experts are concerned about whether these products increase the body's progesterone levels. This
raises the following concerns about over-the-counter progesterone cream use.
- If it is absorbing well. Progesterone treatment has risks. It has been linked to breast
cancer, headaches, and dangerous blood clots in a small number of
women.18 This is why progesterone is usually a
prescription hormone and is not safe for women with certain health
- If it is not absorbing well. If you
are taking estrogen (and have an intact uterus), you also need to have enough
progesterone to prevent the estrogen from causing
uterine (endometrial) cancer.
Talk to your doctor before using an over-the-counter
Testosterone.Testosterone-estrogen is sometimes used for menopausal
symptoms that don't improve with estrogen therapy. But it is not FDA-approved
because its risks are not yet fully known. Testosterone-estrogen carries the
same risks as estrogen treatment (blood clots, stroke, breast cancer) as well
as testosterone risks and side effects.
Testosterone is sometimes used to increase sexual
desire in postmenopausal women who have low testosterone. But, no form of
testosterone is approved for women. Studies have not shown a benefit for longer
than 12 weeks of use, and long-term testosterone risks for women are not yet
known.9 If you have a problem with low sexual
desire, see the topic
Sexual Problems in Women.