Hormone Therapy (Estrogen Therapy, Estrogen/Progestin Therapy)

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Menopause Symptoms

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Some of the symptoms of menopause can actually begin years before menstrual periods stop occurring. Doctors generally use the term "perimenopause" to refer to the time period beginning prior to the menopause (when some of the signs and symptoms of menopause begin to occur) up through the first year following menopause. Menopause itself is defined as having had 12 consecutive months without a menstrual period.

Menopause symptoms begin gradually while the ovaries are still functioning and a woman is still having menstrual periods. These symptoms can begin as early as the 4th decade of life (when a woman is in her 30s) and may persist for years until menopause has occurred. The symptoms occur early because the levels of hormones produced by the ovaries (estrogen and progesterone) decline slowly over time, explaining why pregnancy is still possible, but less likely to occur, as a woman reaches her forties. The severity and duration of symptoms vary widely among individuals - some women may experience only minimal symptoms for a year or two, while others may experience at least some of the symptoms for several years.

While most women will experience a gradual transition to menopause with a slow onset of symptoms, some women will experience an early (premature) menopause that may bring on immediate symptoms, depending on the cause of the ovarian failure. One common cause of immediate symptoms is a "surgical menopause" following the surgical removal of functioning ovaries.

Menopause symptoms can be perceived as physical problems, emotional disturbances, or problems associated with sexual functioning.

Quick GuideMenopause & Perimenopause: Symptoms, Signs

Menopause & Perimenopause: Symptoms, Signs

Hormone therapy facts

  • Hormone therapy (HT) refers to either estrogen or combination estrogen /progesterone treatment.
  • Estrogen therapy is the most highly effective prescription medication for treating menopause symptoms and in light of recent research is still safe and effective for many women when used for fewer than five years.
  • Estrogen therapy reduces or eliminates several symptoms of menopause such as hot flashes, disturbed sleep resulting from hot flashes, and vaginal dryness.
  • Other safe and effective non-hormonal medications exist to address a woman's concerns regarding osteoporosis.
  • The use of estrogen therapy without progesterone (progestin), is associated with an increase in the risk of uterine cancer (endometrial cancer, cancer of the lining of the uterus).
  • Treatment with progesterone along with estrogen substantially reduces the risk of uterine cancer (endometrial cancer) so that the risk of developing this cancer is equivalent to that of women not taking estrogen.
  • Users of oral hormone therapy (HT) (in the doses of the Women's Health Initiative) for more than five years are at slightly increased risk of breast cancer, heart disease, and stroke than are nonusers.

The term "hormone therapy" or "HT" is being used to replace the outdated terminology "hormone replacement therapy" or "HRT."

What is menopause?

Menopause is the stage in a woman's life when menstruation stops and she can no longer bear children. During menopause, the body produces less of the female hormones, estrogen and progesterone. After menopause, the lower hormone levels cause the monthly menstrual periods to stop and gradually eliminate the possibility of becoming pregnant. These fluctuations in hormone levels can also cause troublesome symptoms, such as hot flashes (a sudden sensation of warmth, sometimes associated with flushing, and often followed by sweating) and sleep disturbance. Sometimes women experience other symptoms, such as vaginal dryness and mood changes.

While many women encounter little or no trouble during menopause, others endure moderate to severe discomfort.

Does menopause cause bone loss?

The lower estrogen levels of menopause can lead to progressive bone loss that is especially rapid in the first five years after menopause. Some bone loss in both men and women is normal as people age. Lack of estrogen after menopause adds another strain on the bones in addition to the usual age-related bone loss. When bone loss is severe, a condition called osteoporosis weakens bones and renders them susceptible to breaking.

Medically Reviewed by a Doctor on 8/23/2016

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