Thinking About Hormone Replacement Therapy for Menopause?
Even as winter chills the air, hot flashes may have you feeling like you’re running a fever. If you’re navigating the ups and downs of menopause or perimenopause, you’re not alone. Nicole Pine, PA-C, from Overlake Clinics Bellegrove Ob/Gyn, answers common questions about hormone replacement therapy (HRT), including who it can help, when to start, and how long treatment might last.
Can you use HRT during perimenopause or is it only for menopause?
HRT can be used during both perimenopause and menopause. Perimenopause is the transition period when hormone levels change and symptoms begin to show up, while menopause is defined as 12 months without a period. Most women go through menopause around age 51, while perimenopause often occurs four years prior. Many people begin HRT during perimenopause because symptoms like hot flashes, trouble sleeping, and mood changes can start years before periods stop. It’s important to note that HRT does not prevent pregnancy, so if avoiding pregnancy is a goal, a form of birth control may be a better option.
What symptoms does HRT help with most?
HRT is most effective for hot flashes and night sweats. It can also help improve sleep, mood changes, brain fog, vaginal dryness, painful sex, and some urinary symptoms. For some patients, HRT may also help protect bone health and lower the risk of osteoporosis. However, if someone is not experiencing menopausal symptoms, HRT is not recommended solely for osteoporosis prevention.
How does low estrogen affect my health in the long run?
Estrogen supports bone strength, heart health, skin elasticity, and the health of vaginal and urinary tissues. After menopause, the risk of osteoporosis and heart disease increases. While HRT isn’t prescribed solely to prevent chronic disease, it can provide additional health benefits for some people when used appropriately.
Is HRT safe?
HRT is generally safe when prescribed and monitored by a healthcare provider. Estrogen patches or gels are often safer than pills because they have a lower risk of blood clots. For patients with a uterus, progesterone is always added to protect the lining of the uterus and lower the risk of cancer. Like any medication, HRT has risks that can increase with age and longer use. These may include blood clots, heart attack, stroke, or worsening of certain types of breast or uterine cancer. HRT is generally safest when started near the beginning of menopause. Starting HRT after age 60 is usually not recommended because of the heightened risk of blood clots. Your provider can help you find the type, dose and form of HRT that’s safest for you.
How long do people usually stay on HRT?
There’s no one-size-fits-all answer. Some people use HRT for a few years to manage the most intense symptoms, while others may stay on it longer. In general, when started at the onset of menopausal symptoms, HRT is often used for about 5–10 years. Your provider can help you reassess symptoms, benefits and risks to decide whether continuing HRT is still the right choice.
Ready for personalized guidance? Schedule an appointment with an Overlake Clinics Ob/Gyn provider to talk through your symptoms and explore whether HRT or other treatment options are right for you.
