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Hormone Therapy &
Women's Wellness
If you’ve been suffering from the symptoms of perimenopause or menopause, you’re probably curious about hormone replacement therapy. This therapy replaces the estrogen that your body ceases to produce during menopause. It can relieve annoying symptoms such as hot flashes and vaginal atrophy, and it also defends your bones against osteoporosis and potential fractures.
Hormone therapy is typically individualized to meet your body’s specific needs, based on your age, your medical history and the severity of your symptoms. Keep reading to learn all about hormone therapy and whether it’s right for you.
** We are a private pay / concierge medical office that does not accept insurance. **
Women's Wellness and Bioidentical Hormone Therapy
When you reach menopause in your 40s, your body stops producing as much estrogen as it used to. You can develop some uncomfortable symptoms that diminish your quality of life as a result. Many women experience hot flashes, night sweats, vaginal dryness and mood swings during the perimenopausal and menopausal years. Other unwelcome symptoms of menopause include urinary urgency, insomnia, and dry skin and eyes.
One way to push back against these symptoms and protect your personal well-being is through hormone replacement therapy. By taking in the female hormones that your body is no longer making, you can get through menopause in comfort. As an added bonus, hormone replacement therapy is an effective treatment for osteoporosis, which typically begins during a woman’s 40s and 50s.
Benefits of Hormone Therapy
Study after study has confirmed that bioidentical hormone replacement therapy is beneficial for treating many of the most aggravating symptoms of menopause. It relieves hot flashes and night sweats, so you don’t find yourself hot and uncomfortable at unpredictable times. Hormone therapy also improves your sleep, and it keeps your skin moister and softer.
In addition, hormone replacement therapy relieves the vaginal dryness that occurs during menopause, as well as the itching that plagues many women. Because of this, it helps you continue a normal sex life without the pain that accompanies vaginal atrophy, and it also alleviates the thinning of the vaginal walls that’s common during menopause. In addition, hormone therapy may boost libido.
Hormone replacement therapy has also been proven to protect against osteoporosis and the bone loss that occurs during the menopausal and postmenopausal years. This bone loss frequently leads to fractures and can also be implicated in dental problems and tooth loss. In addition, women taking hormones experience less joint pain as they age.
Hormone therapy also shows benefits in protecting women against heart disease, dementia, colon cancer, stroke and diabetes. Women who take estrogen experience fewer mood changes and a greater sense of overall well-being.
Types of Hormone Therapy
Your hormone replacement therapy is available in two basic types, with many delivery systems available. If you have a uterus, you will be prescribed EPT therapy, which stands for estrogen plus progestogen. Estrogen, the main female hormone, provides most of the symptomatic relief during menopause. Progestogen is added to protect against uterine or endometrial cancer. Women who have had a hysterectomy, and therefore have no uterus, are prescribed estrogen on its own.
Systemic hormone therapy delivers estrogen to your entire body via any of several delivery systems. This type of hormone replacement therapy uses higher doses of estrogen and is effective against the most common (and most irritating) symptoms of menopause.
Most women choose to take their hormone replacement therapy in pill form, taking one estrogen pill a day. Also available is the estrogen patch, which is placed on your abdomen, with estrogen absorbed continually through the skin. Some patches can be worn for up to a week, while others must be replaced every few days. Low-dose estrogen patches are available for women who want to reduce their risk of osteoporosis but don’t need help with menopausal symptoms.
In addition, some women choose topical creams, sprays or gels to introduce estrogen into their bloodstream. These are applied to your arms or legs, depending on the dose and the method of delivery.
If you don’t want systemic hormone therapy, but prefer a topical approach to deal with symptoms affecting your vaginal area, you may want to choose low-dose preparations. These come in several forms as well. You can apply vaginal creams daily or several times a week or take vaginal tablets a couple of times per week. Vaginal rings are inserted for longer periods, with replacements needed every three months or so. These products limit estrogen to your vagina. They’re useful for treating vaginal dryness, vaginal itching and urinary issues, but don’t have any effect on the other symptoms of menopause.
Doctors typically start with the lowest effective dose to see how you respond. Dosages are individualized for each woman’s needs. If you start hormone replacement therapy around the beginning of menopause, you’re most likely to experience the greatest benefits at the lowest risk.
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Questions about Hormone Therapy?
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Who Should Consider Hormone Therapy?
Women who typically handle hormone replacement therapy well include those who start the therapy in their 50s. Women with moderate to severe hot flashes are most likely to benefit from it, as are those who experience pain and discomfort during sexual intercourse due to the vaginal dryness that comes with menopause.
Women who are at risk for osteoporosis may find hormone therapy especially effective, especially if they can’t tolerate other treatments for bone loss, such as biophosphonates. In addition, women who have an estrogen deficiency are helped by hormone replacement therapy. These include women who have experienced early menopause, those with primary ovarian insufficiency and women who have had their ovaries removed.
However, hormone replacement therapy isn’t for everyone. Women with the following conditions should avoid hormone therapy in most cases:
- Blood clots
- Heart disease or previous heart attack
- Gallbladder disease
- Pregnancy (known or suspected)
- Unexplained vaginal bleeding
- Liver disease
- Breast, ovarian or endometrial/uterine cancer
- Stroke
In addition, many doctors recommend that women quit smoking before they embark on hormone replacement therapy.
Is Hormone Replacement Therapy Safe?
For many women, the benefits of hormone replacement therapy far outweigh its risks. But it can increase the risk of several serious conditions, including:
- Blood clots
- Stroke
- Breast cancer
- Heart disease
- Gallbladder disease
The type of estrogen taken and the age at which you begin hormone therapy are important factors when it comes to certain risks. For example, if you still have your uterus and take estrogen without progestogen, your risk of endometrial/uterine cancer rises — but that risk is ameliorated by taking estrogen with progestogen. If you start hormone therapy after mid-life, you may have an increased risk of dementia (but if you start it during mid-life, your risk of dementia is actually reduced). In addition, the risk of breast cancer is more significant with long-term use of hormones.
Your personal health history also plays a factor in the decision to pursue hormone replacement therapy. If you have a personal or family history of any of the serious conditions listed above, you may decide that hormone therapy is not a good choice. Your doctor can help you weigh the risks and benefits against each other.
Regardless of your personal risk, you should plan to take the lowest dosage of estrogen that you find helpful. Your doctor will want to check on you every three to six months to make sure that hormone replacement therapy is still appropriate.
Hormone Therapy for Women in Massachusetts
We’ll help you assess the pros and cons of hormone replacement therapy for your unique body and lifestyle. We’ll listen to your concerns about your menopausal symptoms and go over your medical history to help you make the right decision.
As we listen to your needs, our doctors will help you find the best hormone therapy products and delivery system for you. We’ll make sure you get the lowest dose that you find effective, and we’ll provide the follow-up care you need.
Highly Individualized Hormone Therapy in Greater Boston
We understand that every woman is unique. We want to provide you with the best possible treatment to deal with your menopausal symptoms. That may include hormone replacement therapy — or we may decide together that, for you, the benefits aren’t worth it.
The decision to pursue hormone replacement therapy is a personal one. We are dedicated to having the conversation with you about this choice, taking you through the pros and cons so that you can feel comfortable that you are making the right decision for your health. Make an appointment with us today to learn if hormone therapy is right for you.