Menopause Treatment: Talking with Your Doctor (cont.)

Menopausal Hormone Therapy (MHT)

To help control the symptoms of menopause, some women can take hormones, called menopausal hormone therapy (MHT). MHT used to be called hormone replacement therapy or HRT. The use of MHT has been debated a great deal since the Women's Health Initiative (WHI) Hormone Study findings were released in 2002. Before this study, it was thought that MHT could ward off heart disease, osteoporosis, and cancer, while improving women's quality of life. Findings emerged from clinical trials that showed this was not so.

In fact, long-term use of MHT poses some serious risks. New results from the WHI confirmed that using MHT does not protect against coronary heart disease (CHD, called heart disease here). There is good news, however: The results also suggest that short-term use of MHT does not increase heart disease risk in women who begin MHT within 10 years of onset of menopause. But, it appears that the longer a woman waits to begin MHT after the onset of menopause, the greater her risk of developing heart disease. More research is needed to fully understand this issue. Still, a woman has options when it comes to managing the symptoms of menopause.

During perimenopause, some doctors suggest birth control pills to help with very heavy, frequent, or unpredictable menstrual periods. These pills might also help with symptoms like hot flashes, as well as prevent pregnancy. As you get closer to menopause, you might be bothered more by symptoms like hot flashes, night sweats, or vaginal dryness. Your doctor might then suggest starting MHT.

A woman whose uterus has been removed can use estrogen alone to control her symptoms. But a woman who still has a uterus must take progesterone or a progestin (a man-made progesterone) along with the estrogen. These hormones will probably help with menopause symptoms and prevent the bone loss that can happen at menopause. However, there is a chance your symptoms will come back when you stop MHT.

Once a woman reaches menopause, MHT currently is recommended only as a short-term treatment of moderate to severe symptoms such as hot flashes or night sweats. Women who have problems with vaginal dryness can try lower dose estrogen products, such as vaginal creams, rings, and tablets. Long-term use of MHT is no longer advised, and doctors very rarely prescribe MHT to prevent certain chronic diseases, like osteoporosis. Postmenopausal women should not take MHT as they grow older to prevent problems like heart disease. A woman should talk about the benefits and risks of using MHT with her doctor to decide if MHT is right for her.