22 Mar Keep Your Active Lifestyle After Menopause with Hormone Replacement Therapy
By Emily A. McInnis, D.O.
You’re healthy, you’re active, and then all of a sudden you start to notice some strange changes. For women who are around 50 years old, the time has likely come for menopause. While this will take some adjustment, it’s really nothing to fear or be upset about. It happens to all women when you get to a certain stage of life, and we have the option at Sylacauga OBGYN to help you with hormone replacement therapy (HRT).
HRT will give you the opportunity to enjoy your life to the fullest because you will feel better! Here is more information about menopause, how HRT works, and what to expect when it’s time to get started.
Why Hormone Replacement Therapy is Needed
In America, the median age of menopause is 51 years. Most women begin to undergo the physiologic changes associated with menopause in the years preceding the final menstrual period. This interval is often referred to as perimenopause. Most women experience menopause between the ages of 45 and 55.
Menopause is the permanent cessation of menstruation that occurs after the loss of ovarian activity. By definition, we determine that menopause has occurred when you have gone one year with no menstrual period.
HRT, with estrogen alone or in combination with progestin, is the most effective therapy for symptoms, known as vasomotor symptoms, related to menopause. The most common symptoms include:
- Hot flashes
- Night sweats
- Mood swings
- Vaginal dryness and irritation
Another symptom that may occur is the sudden sensation of extreme heat in the upper body, particularly the face, neck, and chest. We refer to this as a hot flush. These episodes, which typically last 1 to 5 minutes, can be characterized by perspiration, flushing, chills, clamminess, anxiety, and, on occasion, heart palpitations.
These episodes vary in frequency and duration. Studies show that 87% of women who report hot flushes experience these symptoms on a daily basis, with approximately 33% experiencing more than 10 hot flushes per day. Symptoms may persist from six months to two years, although the overall duration of hot flushes remains unclear and is different for everyone.
It’s also common to experience a loss of estrogen in the vagina which causes the thinning of tissue. Loss of elasticity occurs with a narrowing and shortening of the vagina. These thin tissues are more fragile and may tear, leading to bleeding and fissures. This is the cause of several menopausal complaints such as vaginal or vulvar dryness, discharge, itching, and pain with sex.
Lastly, some women notice mood changes as well as new depression/anxiety symptoms. Vasomotor symptoms may also interfere with sleep and cause chronic sleep disruption in some women.
How Hormone Replacement Therapy Can Help
For HRT, we use estrogen alone or in combination with progestin to effectively treat these vasomotor symptoms related to menopause. Data do not support the use of progestin-only medications, testosterone, or compounded bioidentical hormones for the treatment of menopausal symptoms. Several different forms of HRT therapy are available including oral, vaginal, creams, and patches.
HRT works by simply replacing the hormones that are not being produced anymore by the ovaries. We typically see a 75% reduction in weekly hot flush frequency in users of oral estrogen or oral estrogen plus progestin.
When it’s your time to consider HRT, all you’ll need to do is schedule a visit with us to chat about what you are experiencing. Because menopause is defined by lack of cycles for one year, we can usually go by this information or symptoms alone for a diagnosis. Additionally, there are labs we can check to confirm menopause status, such as follicle-stimulating hormones (FSH) and estrogen levels. However, “checking your hormones” does not really give us much information because these levels change daily.
If you are strictly having vaginal symptoms, we would likely suggest a cream, suppository, or gel inserted vaginally to help. This can be safely prescribed to all ages because it is only a localized effect.
We start oral/transdermal HRT in women younger than 60 years and within 10 years of menopause. There has been shown to be a cardioprotective effect of HRT for women in this group, and it can also decrease your chances of developing colon cancer or fractures.
We will also ask you several questions such as history of strokes, blood clots, or if you are a smoker. If the answer to any of these questions is yes, you may not be a candidate for HRT due to increased risks of blood clots in this population.
Continue Your Active Lifestyle
Whether your days are full of going to a job you enjoy, providing childcare for grandchildren, gardening, taking long walks, or all of the above, going through menopause does not have to change any of that. HRT is a wonderful option for many people that allows them to continue being active and doing all the things they love while also feeling their best.
If you are in this stage of life, and you think it might be time to try HRT, come chat with us about it! We will be happy to help you get started.
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