Health Issue: Menopause

Treatment with hormones may be helpful if you have severe menopause symptoms such as hot flashes, night sweats, or vaginal dryness.

Discuss the decision to take hormones thoroughly with your doctor, weighing your risks against any possible benefits.

HORMONE REPLACEMENT THERAPY

Several major studies have questioned the health benefits and risks of hormone replacement therapy, including the risk of developing breast cancer, heart attacks, strokes, and blood clots.

Current guidelines support the use of HRT for the treatment of hot flashes. Specific recommendations:

• HRT may be started in women who have recently entered menopause.
• HRT should not be used in women who have started menopause many years ago.
• The medicine should not be used for longer than 5 to 7 years.
• Women taking HRT should have a low risk for stroke, heart disease, blood clots, or breast cancer.

To reduce the risks of estrogen replacement therapy and still gain the benefits of the treatment, your doctor may recommend:

• Using estrogen or progesterone regimens that do not contain the form of progesterone used in the study
• Using a lower dose of estrogen or a different estrogen preparation (for instance, a vaginal cream rather than a pill)
• Frequent and regular pelvic exams and Pap smears to detect problems as early as possible
• Frequent and regular physical exams, including breast exams and mammograms

ALTERNATIVES TO HRT

There are some medications available to help with mood swings, hot flashes, and other symptoms. These include low doses of antidepressants

LIFESTYLE CHANGES

The good news is that you can take many steps to reduce your symptoms without taking hormones:

• Avoid caffeine, alcohol, and spicy foods
• Dress lightly and in layers
• Eat soy foods
• Get plenty of exercise
• Perform Kegel exercises daily to strengthen the muscles of your vagina and pelvis
• Practice slow, deep breathing whenever a hot flash starts to come on (try taking six breaths per minute)
• Remain sexually active
• See an acupuncture specialist
• Try relaxation techniques such as yoga, tai chi, or meditation
• Use water-based lubricants during sexual intercourse