Help! I’m All Out Of Estrogen

Women who are nearing menopause will reduce or completely stop producing estrogen. Hormone replacement therapy (HRT) is a treatment option that can re-supply women’s bodies with estrogen alone or with an estrogen and progesterone combination. HRT can be an extremely effective treatment for reducing uncomfortable menopause symptoms. In some women, however, HRT can be accompanied by some risks. Here’s what questions to ask a doctor when considering HRT.

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I’ve heard HRT has risks; do I need to worry?

Most women will experience some side effects of HRT, such as headaches, nausea, and breast pain. HRT can pose some more serious health risks for some women. In some studies, HRT has been shown to increase risks of heart disease, stroke, blood clots, and breast cancer.

However, these risks vary on an individual basis. Women who start HRT after the age of 60 or 10-20 years prior to the start of menopause have an increased risk of these serious conditions. Women who start HRT prior to 60 and within 10 years of menopause see more benefit than risk to HRT. Additionally, women should discuss any personalized risk factors such as family history, heart disease, and cancer risks with a healthcare provider when considering HRT.

How do I know if HRT is an option for me?

For women who don’t have the above risk factors, HRT is the most effective treatment for unmanageable menopausal symptoms. Some signs that a woman might be a good candidate for HRT include:

  • severe hot flashes, mood swings, vaginal dryness, and difficulty sleeping
  • loss of bone mass with no effective treatment
  • premature menopause (prior to age 40) or loss of normal ovary function before age 40.

What are the pros and cons of different HRT types?

For women who have had a hysterectomy, doctors will likely prescribe estrogen therapy. Estrogen can come in the form of a patch, pill, vaginal ring, gel, or spray. Each of these different HRT options has been proven effective for reducing menopausal hot flashes, night sweats, and vaginal discomfort.

Women who still have a uterus will likely undergo a combination therapy of estrogen and progesterone or progestin. Combining estrogen with progesterone reduces a woman’s risk of cancer of the uterine lining, or endometrium.

Will I need follow-up care after I start HRT?

Though HRT is an effective treatment, it is one that requires regular check-in and adjustment. Experts recommend checking in with a doctor about HRT treatment every 3-6 months. Women who are good candidates for HRT may still experience some bloating, mood changes, and vaginal bleeding. If at any time a woman is concerned about any of these side effects, experts recommend consulting with a doctor right away.


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