Menopause Treatments

• Benefits and Risks of Hormone Therapy
• Natural Treatments for Menopause
• Symptom Relief
• Track Your Symptoms
• Stay Healthy As You Age

As you near menopause , you may have symptoms from the changes your body is making. For some women, their menopause symptoms will go away over time without treatment. Other women will choose treatment for their symptoms. Treatments may include prescription drugs that contain types of hormones that your ovaries stop making around the time of menopause. Hormone therapy can contain estrogen alone or estrogen with progestin (for a woman who still has her uterus or womb). Estrogen therapy usually is taken by pill, skin patch, as a cream or gel, or with an intrauterine device (IUD) or vaginal ring. How estrogen is taken can depend on its purpose. For instance, a vaginal ring or cream can ease vaginal dryness, leakage of urine, or vaginal or urinary infections, but does not relieve hot flashes. If you want to prevent bone loss, you also should talk with your doctor about medicines other than hormone therapy that can help your bones.

Benefits and Risks of Hormone Therapy

According to the American College of Obstetricians and Gynecologists, hormone therapy gives women the best relief of menopausal symptoms. However, there are risks. Talk to your doctor about the risks and benefits to decide what the best treatment is for you.

Benefits of hormone therapy:

• reduce hot flashes
• treat vaginal dryness
• slow bone loss
• decrease mood swings and depression

DO NOT use hormone therapy to prevent heart attacks, strokes, memory loss or Alzheimer's disease. Also know that there also are other medicines that can help your bones.

Risks of hormone therapy: increased risk of

• blood clots
• heart attacks
• strokes
• breast cancer
• gall bladder disease

For a woman with a uterus, taking estrogen alone, without progesterone, increases her chance of getting endometrial cancer, or cancer of the lining of the uterus. Adding progesterone to the hormone therapy lowers this risk. For women who've had a hysterectomy, taking estrogen alone could raise the risk of blood clots and stroke.

Hormone therapy also may cause these side effects:

• bleeding
• bloating
• breast tenderness or enlargement
• headaches
• mood changes
• nausea

Who should NOT take hormone therapy for menopause:
Women who

• think they are pregnant
• have problems with vaginal bleeding
• have had certain kinds of cancers, such as breast and uterine cancer
• have had a stroke or heart attack
• have had blood clots
• have liver disease

We know that hormone therapy may be a way to get over the symptoms of menopause if taken for only a short time and in the smallest amount. Hormones do NOT help prevent heart or bone disease, stroke, memory loss or Alzheimer's disease. If you decide to use hormones, use them at the lowest dose that helps and for the shortest time needed. Check with your doctor every year to see if you still need them. Because there are both benefits and risks linked to taking them, every woman should think about these in regard to her own health and discuss these issues with her doctor. We are still trying to learn more about the long- and short-term effects of hormone therapies on women's health. For more information on the risks and benefits of hormone therapy, go to http://www.nhlbi.nih.gov/health/women/index.htm.

Natural Treatments for Menopause

Some women decide to take herbal, natural, or plant-based products to help their symptoms. But there is not enough evidence to know if treatments like these are helpful in relieving menopausal symptoms. Tell your doctor if you are taking any of these treatments. They may have side effects or make another drug not work as well. Some of the most common ones are:

• Soy. This contains phytoestrogens (estrogen-like substances from a plant). Some research has shown that soy food products can help with mild hot flashes. The risks of taking soy, especially the pills and powders, are not known. Also, soy may not be safe for women with estrogen-dependent breast cancer.
• Other sources of phytoestrogens. These include herbs, such as black cohosh, wild yam, dong quai, and valerian root.
• Bioidentical hormone therapy. Some women visit alternative medicine doctors and get a prescription for these products, which are made from different plant hormones that are like those in a woman's body. Each prescription is hand-mixed, and the dose can vary from patient to patient. Products that come from plants may sound like they are more natural or safer than other forms of hormones, but there is no proof they really are. There also is no proof that they are better at helping symptoms of menopause. Make sure to discuss herbal products with your doctor before taking them. You also should tell your doctor if you are taking any other medicines, since some of the herbal products can be harmful to take with other drugs.