Finding Balance With Menopause

A woman will go through several stages in life, including menopause. Typically known for hot flashes, mood swings, and even difficulty sleeping, the process is an inevitable rite of passage that simply indicates that a woman can no longer menstruate. However, other unwanted symptoms can include difficulty sleeping, lowered sexual drive, depression, and, most notably, hormonal imbalances. In particular, changing hormone levels can increase a woman’s chances of experiencing unintended health issues such as an increased risk of osteoporosis, cardiovascular disease, and even recurrent urinary tract infections. To combat those issues, many physicians will recommend a woman undergo hormone replacement therapy (HRT) and sometimes with modifications to customize the treatment.

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What is HRT?

The two most common types of HRT delivery typically rely on low-dose vaginal or systemic hormone therapy. Systemic hormone therapy is absorbed through the body and leverages a topical item like gels, creams, rings, or a patch worn on the skin. Low-dose vaginal hormone treatments deliver medication through similar methods like rings, creams, and tablets but have much lower levels of estrogen. In most cases, low-dose solutions are typically prescribed for people who only experience menopause symptoms in the urinary tract or vagina.

When testosterone is recommended

Not every woman experiencing menopausal symptoms is a good candidate for HRT with testosterone. Research shows that testosterone is usually only recommended in specific scenarios, including for individuals who struggle with low sex drive, concerns over bone density and muscle mass loss, cognitive functional decline, dysregulated mood, and low energy. In most cases, testosterone is prescribed as a supplemental solution when traditional HRT isn’t enough to correct menopausal changes.

HRT has limitations

HRT is usually one of the first recommendations offered to treat symptoms in most menopausal women but is not a one-size-fits-all solution. If a woman previously had a hysterectomy or HRT with progesterone, future hormone treatments might be avoided. By contrast, women who didn’t have the surgery may find that a combination of estrogen with progesterone works to alleviate symptoms. A dual therapy solution can reduce the risk of endometrial cancer, which is usually higher in women only using supplemental estrogen.

Understanding HRT risks

Just like any medication, HRT isn’t free from risks. Women who haven’t had a hysterectomy but are using estrogen can still be at a higher risk of endometrial cancer. Other potential threats include strokes, blood clots, gallbladder and gallstone issues, and dementia, depending on when HRT is started. Likewise, breast cancer is another factor to consider in long-term users. Similarly, incorporating testosterone therapy can have the same risks as stated above, as well as potential physical changes like acne, hair growth, weight gain, and mood changes.

Making an informed choice

To date, physicians can’t offer a hard timeline for starting or stopping HRT. Governing bodies do offer guidelines designed to minimize side effects. The general recommendation is that physicians should aim to prescribe the lowest dose that can effectively treat menopausal issues. Additionally, women undergoing HRT, whether with estrogen, progesterone, or testosterone, are urged to maintain routine hormone level monitoring to avoid complications.

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