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.

Symptom Relief

Follow these tips to help relieve menopausal symptoms.

Hot Flashes. A hot environment, eating or drinking hot or spicy foods, alcohol, or caffeine, and stress can bring on hot flashes. Try to avoid these triggers. Dress in layers and keep a fan in your home or workplace. Regular exercise might also bring relief from hot flashes and other symptoms. Ask your doctor about taking an antidepressant medicine. There is proof that these can be helpful for some women.
Vaginal Dryness. Use an over-the-counter vaginal lubricant. There are also prescription estrogen replacement creams that your doctor might give you. If you have spotting or bleeding while using estrogen creams, you should see your doctor.
Problems Sleeping. One of the best ways to get a good night's sleep is to get at least 30 minutes of physical activity on most days of the week. But, avoid a lot of exercise close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. You might want to drink something warm, such as herb tea or warm milk, before bedtime. Try to keep your bedroom at a comfortable temperature. Avoid napping during the day and try to go to bed and get up at the same times every day.
Memory problems. Ask your doctor about mental exercises you can do to improve your memory. Try to get enough sleep and be physically active.
Mood swings. Try to get enough sleep and be physically active. Ask your doctor about relaxation exercises you can do. Ask your doctor about taking an antidepressant medicine. There is proof that these can be helpful. Think about going to a support group for women who are going through the same thing as you, or getting counseling to talk through your problems and fears.

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Track Your Symptoms

You can use this chart to keep track of menopausal symptoms that bother you. Take it with you when you visit your doctor, so you both can figure out the best way to handle them.

Date	Symptoms	Things I've tried to help them	Questions for my doctor	New things to try

Stay Healthy As You Age

Take these steps to stay healthy during this time in your life:

Be active. Try to get at least 30 minutes of physical activity on most days of the week. Try weight-bearing exercises, like walking, running, or dancing.
If you smoke, quit. Ask your doctor for help. Visit www.4woman.gov/QuitSmoking for more information.
Eat healthy foods. Eat a variety of fruits and dark green veggies, such as broccoli, kale, and other dark leafy greens; get calcium-rich foods; eat whole-grain cereals, breads, crackers, rice, or pasta; choose lean meats and poultry; and limit saturated fats and salt.
Limit alcohol. If you drink alcohol, limit to no more than one drink each day.
Control your weight. Ask your doctor what a healthy weight is for you.
Ask your doctor what tests you need. Have your blood pressure, cholesterol, and blood sugar checked. Have breast exam and a breast x-ray (mammogram).
Talk to your doctor about bone health. Ask your doctor if you're getting enough calcium and vitamin D. Get a bone density test if you're over 65, or if your doctor says you have a high chance of getting osteoporosis. Ask about taking medicine to help preserve bone and slow down bone loss. Get enough calcium to keep your bones strong. Before menopause, you need about 1,000 mg of calcium per day. After menopause, you need 1,500 mg per day.

Source: www.4woman.gov

Menopause Treatments

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