Introduction
Menopause is a natural process that occurs among women. In this stage, the menstrual cycle ends. It may occur among women between the ages of 40 and 50. For some of the women, it may start in 30 years. It is estimated that every year, 1.5 million people enter the transition phase of menopause called perimenopause. In this natural process, hormone levels keep decreasing. Hormone replacement therapy (HRT) can be used to manage this condition.
What Is Menopause?
Menopause is an important stage in a woman’s life. It is considered a natural biological process that occurs when the menstrual cycle ends and is diagnosed when it does not occur for 12 months. It may bring about many changes, such as mood changes, decreased energy, and disturbances in sleep.
Symptoms of menopause include,
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Irregular menstrual cycles.
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Dryness is seen in the vagina.
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Hot flashes may be experienced.
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Night sweats may be seen.
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Emotional health is affected by mood changes.
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Problems related to sleep.
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Weight gain may slow down the metabolism.
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Hair becomes thin.
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Dryness of the skin is observed.
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Loss of breast fullness occurs.
Signs and symptoms may differ from one woman to another. But before the menstrual cycle ends, some symptoms or irregularities may be observed.
What Is Hormone Replacement Therapy?
HRT is a medication that contains female hormones. Decreased estrogen levels cause menopause. This can be managed by replacing it with hormones. Hormone replacement therapy during menopause can be called menopausal hormone therapy (MHT) or estrogen therapy. This type of treatment is considered the most effective. MHT involves estrogen, progesterone, and testosterone.
MHT or Estrogen Therapy:
Estrogen therapy is given to those women with symptoms of menopause that may be due to a hysterectomy (removal of the uterus with surgery) or hysterectomy with bilateral salpingo-oophorectomy (surgical removal of the uterus, fallopian tubes, and ovaries). Estrogen is available in different forms, like pills, patches, and hormones are available in the form of a vaginal ring, gel, or spray.
Estrogen Pills: These are the most commonly used for the treatment. There are different forms of pills. These include conjugated estrogen or estrogen bazedoxifene. These are usually given once a day before food. Some may have difficult dosing patterns.
Topical Estrogen: Creams, gels, or sprays may be used for topical application. The skin easily absorbs this medication and enters the bloodstream.
Estrogen Patch: This patch is worn on the skin of the abdomen. Depending on the dose, these can be worn for two days, or some may be kept for weeks.
Vaginal Estrogen: These are available in the form of cream, gel, or sprays. These are used for vaginal dryness, itchiness, burning sensations, or pain during intercourse.
Estrogen, Progesterone, or Progestin Hormone Therapy: Two or more hormones are combined in this type. Estrogen and progestin (a synthetic progesterone) are given in combination. This type of therapy is meant for women who still have a uterus. When estrogen and progesterone are both given, it helps protect against the risk of cancer of the endometrium (lining of the endometrium) better than giving estrogen alone. Progesterone alone, used for birth control, can be used to treat symptoms of menopause, like hot flashes.
Oral Progestins: Natural progesterone is used for menopausal symptoms rather than synthetic. Research has suggested that natural progesterone does not affect lipids and is a better alternative for women with cholesterol problems.
Intrauterine Progestin: These are used for preventing pregnancy and controlling bleeding. If a woman entering perimenopause has an intrauterine device (IUD), a doctor may advise that woman to keep it until the perimenopause (early menopause) is completed. This may help with irregular menstrual periods.
Women in their early menopause may benefit from MHT. Premature menopause or early menopause may result in reduced levels of estrogen. This may lead to other issues, like
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Cardiovascular disease.
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Osteoporosis (bones becoming brittle).
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Parkinson’s disease.
These risks should be avoided or reduced by taking MHT until the age of menopause.
What Are the Added Benefits of Hormonal Therapy?
MHT can help reduce the risk of chronic conditions like
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Osteoporosis.
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Heart disease.
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Endometrial cancer.
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Bowel cancer.
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Type 2 diabetes.
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Cataracts.
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Alzheimer’s disease.
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Stroke.
Along with these, all the menopausal symptoms can be reduced.
What Are the Risks of Hormonal Therapy?
The reaction to MHT is different from one woman to another. Some may not show any risks but others may show.
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Nausea.
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Experience fluid retention.
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Sore breasts.
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Vaginal bleeding continues for 6 months.
Many symptoms may be resolved within 3 months.
MHT-related health risks depend on
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When MHT was started.
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How long has the usage of MHT been done?
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Type and dose of medication.
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Medical history of the person.
MHT cannot be prescribed for those with hormone-dependent cancers like breast cancer and some uterine cancer. Other health issues, such as heart disease and vaginal bleeding, are also contraindicated for MHT.
MHT and Weight: Weight gain may be observed during menopause. The reason for weight gain is age and other lifestyle factors like reduced physical activity. Hormonal variations that occur due to menopause may be responsible for fat storage around the belly. This may be reduced by treating it with MHT after menopause.
MHT and Contraception: The fertility of a person decreases with age. It is not an exception to conceive during these days. This may occur before menopause but not after menopause. If women are younger than 50 years, they are supposed to use contraception for 2 years. If women are 50 and older, they must have been using contraception for at least one year.
What Are Other Treatments for Menopausal Symptoms?
There are other options for treating menopausal symptoms other than MHT.
These include,
Medications: Nonhormonal medications like antidepressants, epilepsy medications, and medications used to treat high blood pressure are used.
CBT (Cognitive Behavioral Therapy): it is an option of treatment used in the management of psychological problems like depression, anxiety, and other mental illnesses.
Hypnotherapy: It is a state of altered awareness in which an increased relaxation state can be seen.
Lifestyle Changes: Lifestyle modifications such as regular exercise, a healthy diet, and weight loss help reduce menopausal symptoms.
Complementary Therapies: These types of therapies and certain medications may be beneficial for managing the symptoms of menopause.
Conclusion
Menopause is a natural process that occurs in every woman. Symptoms experienced are different from one woman to another. These can be effectively tackled with hormone replacement therapy. Hence, it becomes important to know about menopause, hormone replacement therapy, its risks, and its benefits. Knowing helps one identify the condition early and approach treatment. Early diagnosis leads to effective treatment, which in turn helps achieve a good quality of life.
