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Shedding light on hormones during menopause

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You just started menopause and several of its symptoms are bothering you. You’ve heard about hormone therapy, but are wondering whether it’s a good solution since it is still controversial. What to do? Let’s find out more.

Les hormones durant la ménopause

Taking a look at hormones

Many women dread the arrival of menopause and its associated symptoms. Indeed, this stage of life comes with significant changes on both the psychological and physiological levels. Hormone therapy can then seem like an interesting solution to alleviate the symptoms of menopause. However, the therapeutic use of hormones is not suited to all women, so it is imperative to act with caution.

Menopause occurs after a gradual decrease in the synthesis of two reproductive hormones, estrogen and progesterone. Ovulation then ceases, marking the end of a woman’s fertile period. In addition, several unpleasant symptoms can occur due to less estrogen flowing through the body.

To treat the symptoms of menopause, estrogen supplements are used in order to make up for the body’s decreased production. If a woman still has her uterus, a progesterone supplement is added. This treatment, named hormone therapy, is administered:

  • orally (tablets);
  • topically (patch or gel to apply on the skin);
  • vaginally (tablet, ring or cream).

Here are some of the symptoms that can be alleviated by hormone therapy:

  • hot flashes;
  • vaginal dryness;
  • thinning of vaginal lining.

Hormones can also be used, in some cases, to prevent osteoporosis.

Shedding light on the controversy

As it stands today, hormones are a valid treatment option for menopausal women. However, the results of scientific research published in the past few years have cast doubt upon their safety. Indeed, it is true that hormones can slightly increase the risk of developing certain diseases, such as the following:

  • breast cancer;
  • embolism (formation of a blood clot in a limb, lungs or brain);
  • cardiovascular diseases.

Since these results were published, there have been a few adjustments made to hormone prescriptions so as to reduce risks. In general, these rules must now be followed:

  • Hormones must be prescribed in the lowest dose possible, and for the shortest time possible.
  • Hormones can no longer be prescribed solely to prevent cardiovascular diseases. In terms of osteoporosis prevention, the use of hormones must be evaluated in comparison with other available treatments.

Who can take hormones?

Hormone therapy can be indicated and effective in cases where the symptoms of menopause are severe, i.e. when they are not alleviated by non-medicinal measures and are an obstacle to daily activities. Hormones cannot be prescribed in the following cases:

  • allergy to hormones;
  • history of breast or endometrial cancer;
  • liver disease;
  • abnormal uterine bleeding;
  • history of blood clots;
  • history of cardiovascular diseases (stroke, heart attack, etc.);
  • migraines;
  • coagulation problems;
  • pregnancy;
  • visual loss resulting from a disease affecting the eyes’ blood vessels.

In addition, hormone therapy is not right for women who smoke because their risk of cardiovascular events is higher.

This does not mean that hormone therapy must no longer be used. It only means that every woman must determine the pros and cons of this therapy for herself. In cases where the benefits for relief of symptoms are great and the health risks are low, it is appropriate to use this type of treatment.

In order to determine if hormone therapy is suitable for you, your doctor will ask you questions about your symptoms, your family history and any medication you are taking. She or he can then evaluate the risks and benefits of hormone therapy and make a decision that will protect your health. Note that the final decision to use replacement hormone therapy is yours to make.

Treatment

If your doctor believes that hormones are a good treatment option for you, he or she will then choose the most appropriate way to administer them. Transdermal (on the skin) hormones have the advantage of minimizing cardiovascular risks, so this method is considered to be the safest in women who are at risk of cardiovascular diseases. If you suffer from a symptom that is more localized, such as vaginal dryness, vaginally administered hormones may be suggested.

Taking replacement hormones can lead to some side effects. Your pharmacist is in a great position to explain the effects you might see appear, in addition to providing advice on the best way to take your medication.

To summarize, hormones still have a role to play in the array of treatments for menopause symptoms. When they are used correctly, they can be of great help to women who are struggling with severe symptoms by considerably improving their quality of life. Every woman must, however, weigh the pros and cons before starting such a treatment. Information is your best tool to make a wise decision regarding hormone therapy… knowledge is power!

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