Is Hormone replacement therapy safe

You’re tired, and your brain is foggy. Night sweats disrupt your sleep. Hot flashes interrupt your workday. You’re gaining weight, and sex hurts. These days, you just don’t feel like yourself.

The culprit? Menopause.

Here’s the good news: While the end of your monthly period is inevitable, the symptoms associated with it are not. You just need the right guidance.

As a physician, gynecologist, and certified menopause provider, I’m here to offer you the help and guidance you need. You are not alone!

Every year, 2 million women in the U.S. become menopausal. Eighty percent experience symptoms in the years leading up to (perimenopause) and after menopause. They may experience hot flashes, insomnia, weight gain, mood swings and many more. These symptoms are a result of the sudden decline in hormones, particularly estrogen, and typically last 7 to 10 years, or longer. This reduction in hormones is a shock to the system, and it takes years for most women to adjust to these new levels.

In the meantime, symptoms can be debilitating, impacting your relationships, work, and health. And yet, studies show that only about 8% of American women who ask for help actually receive the help they need. They’re told their symptoms will pass, or that treatment is unsafe. Why the confusion? Because most primary care doctors and gynecologists are not adequately educated on menopause and its treatment.

For years, hormone replacement therapy (HRT) was the gold standard for treating menopause. HRT is typically a combination of estrogen and progesterone. All of that came to an abrupt halt when a large study called the Women’s Health Initiative was published in 2002. The study was misleading as it grouped all women across age groups together, suggesting HRT increased the risk of heart disease and breast cancer, as well as stroke and blood clots.

Doctors, myself included, became nervous about prescribing hormones. Most women stopped taking their hormones, either on their own, or based on their physicians’ recommendation.

But women were suffering terribly. Desperate, they turned to online sites or poorly informed providers, where they were offered herbal medicines, topical over-the-counter hormones, or vitamins. Unfortunately, none of these options have been proven to work, and symptoms persisted.

Today, after careful scrutiny, we know that Hormone Replacement Therapy remains the best treatment for your symptoms. New studies since 2002 show that HRT prescribed before age 60 and within 10 years of menopause will reduce a woman’s chance of dying and of developing a major illness such as diabetes. What’s more, hormones will lower the risk for heart disease, bone fractures and colon cancer.

But what about the WHI study? Most of the women in that study were over the age of 60, with an average age of 63. The majority were 10 years beyond menopause, and only 13% had bothersome symptoms. What came out in the press didn’t reflect what we now know, that HRT does work when it’s given at a younger age and earlier in menopause, or even perimenopause.

While there may be some for whom HRT is not the right choice, for the vast majority, it is the best thing for general health and wellbeing. You are unique, so let’s find the right treatment for you before it is too late.

It’s time to give HRT a second look. It’s time to apply relevant, medical science to the treatment of your menopause systems.

Sandra Fleming, MD, FACOG, NCMP