Menopause is the point in a woman's life when she has not had a menstrual period for 1 year. Menopause marks the end of the childbearing years. It is sometimes called "the change of life."
For most women, menopause happens at around age 50, but every woman's body has its own time line. As you get closer to menopause, your estrogen levels go up and down unevenly. This causes changes in your period and other symptoms, such as hot flashes, headaches, and sleep problems. After your estrogen levels drop past a certain point, your menstrual cycles end.
Menopause is a natural part of growing older. You don't need treatment for it unless your symptoms bother you.
Hormone therapy uses a combination of two hormones, estrogen and progestin. You can take the hormones as pills, use a patch, or use a vaginal ring. HT increases the estrogen and progestin levels in your body. It can prevent osteoporosis and ease menopause symptoms such as hot flashes and sleep problems.
Because of the risks from HT, many experts recommend that HT be used:
Menopause symptoms can be upsetting and uncomfortable. But you don't have to suffer through them. There are other things besides taking HT that you can do to help.
The first step is to have a healthy lifestyle. This can reduce your symptoms and also lower your risk of heart disease and other long-term problems linked to aging. Eat a heart-healthy diet, get regular exercise, don't smoke, and limit caffeine, alcohol, and stress.
If you still need help dealing with symptoms, you might try:
To manage symptoms before you start menopause, you might think about taking low-dose birth control pills, if you don't smoke and aren't at risk for heart disease or breast cancer.
Risk varies based on when you start HT in menopause and how long you take it. Short-term use of hormone therapy in early menopause has less risk than when it is started later in menopause.
Women who take HT have slightly higher rates of:1
Your risk will differ based on your personal or family history.
If you have had breast cancer, taking HT isn't safe for you.
Your doctor may recommend HT if:
|Take HT||Don't take HT|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Side effects can include:
Women who take HT may have slightly higher rates of:
Some risks depend on your age, when HT is started, and how long it is used.
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I've been very fortunate. Like my mother, I made it through menopause without hot flashes or other major discomforts. My doctor tells me that all I have to do now is be sure I get my regular checkups and exams, take calcium and vitamin D for bone health, and take good care of myself."
— Karen, age 55
"By the time my periods stopped, I didn't have bad hot flashes or other problems. I was pretty proud of myself for getting exercise and eating right, and thought that I was one of the lucky ones. Did I get hit, though! The night sweats started a few months after my last period, and I couldn't sleep or get through the day after that. So, I tried low-dose HT for 6 months, to get some relief. Then, I tapered off of it over a few months, and they weren't as bad. I figure I can tough it out now till my body adjusts to its new state."
— Jane, age 52
"My doctor told me that HT would help me in so many ways, so I started taking it after my periods stopped. The problem is, I had bleeding on and off that was like my period, and I just couldn't take it after 6 months. I haven't taken it since, and I've grown used to my body's changes. I still get hot flashes sometimes but not like I used to. When I feel one coming on, it really helps me to do relaxation breathing. I think that calming my body and mind has a big effect on making a hot flash go away."
— Mary Anne, age 60
"I have already had a terrible time with perimenopausal moodiness and some occasional hot flashes, and low-dose birth control pills have helped even out the hormone ups and downs. So I know what my plan is. When my doctor gives me the go-ahead around menopause age, I'm going to switch to low-dose HT. Then I'll taper off of it after a year or so. I need to be able to function!"
— Jenessa, age 45
"There is no way I'd ever take estrogen or progestin, because of the cancer risks. There's just too much we don't know, and what we do know from recent studies scares me. I used an antidepressant when my hot flashes were bad, and that helped me a lot. Now, I just take calcium and vitamin D supplements and get regular exercise to help protect my bones."
— Sondra, age 55
"A girlfriend told me that she was having great results from taking black cohosh, so I tried it for the occasional hot flashes and mood swings I was having. I think it's working quite well. But it wasn't until I went for my annual gyn exam that I learned it's best to have a checkup every 6 months, like women in Germany who take it by prescription. Now I know to think of black cohosh as a prescription drug, kind of like estrogen, that's still being studied."
— Sam, age 49
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to use hormone therapy
Reasons not to use hormone therapy
Other treatment hasn't helped me deal with my menopause symptoms.
I want to try other treatment before I try HT for my symptoms.
The benefits of HT outweigh the risks for me.
I feel the risks from HT are too high for me.
I don't mind taking medicines to help me manage my symptoms.
I don't want to take medicines if I can avoid them.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
NOT using HT
1. Does taking HT raise your risk of health problems and disease?
2. Can HT help you deal with menopause?
3. Are there other treatments that can help with menopause symptoms?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Anne C. Poinier, MD - Internal Medicine|
|Specialist Medical Reviewer||Carla J. Herman, MD, MPH - Geriatric Medicine|
North American Menopause Society (2012). The 2012 hormone therapy position statement of the North American Menopause Society. Menopause, 19(3): 257–271. Also available online: http://www.menopause.org/PSht12.pdf.