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- A woman has reached menopause when she has not had a period for 12 months in a row. It is a normal change in a woman's life.
- During menopause a woman's body slowly produces less of the hormones estrogen and progesterone. This often happens between the ages of 45 and 55 years old.
- Lower hormone levels in menopause may lead to hot flashes, vaginal dryness, mood swings, sleep disorders, urinary problems and decreased sexual desire.
- No two women will experience menopause in the exact same way.
- Hormone replacement therapy (HRT), hormone therapy (HT) or menopausal hormone therapy (MHT) can refer to the use of estrogen alone or to a combination of estrogen and a progestin. Occasionally, testosterone may be added to treat decreased libido. Other terminology includes ERT (estrogen replacement therapy) and ET (estrogen therapy) for estrogen only; EPT (estrogen progestin therapy) for combination estrogen and progestin.
- Like all medicines, hormone therapy has risks and benefits.
- The Women's Health Initiative found:
- The risks of combined estrogen and progestin hormone replacement therapy (HRT) outweigh its benefits by increasing risk for heart disease, breast cancer, stroke and blood clots.
- Estrogen-only therapy can put women at increased risk of stroke.
- HRT increases breast density, making breast cancer more difficult to detect.
- The Women's Health Initiative Memory Study (a sub-study of the WHI) reported HRT may double the risk of Alzheimer's disease and other dementias in women over 65.
- Pre-market clinical trials do not uncover all possible risks nor do they guarantee the absolute safety of a drug. Side effects may appear only when a drug is used in combination with another medicine, in patients who were not represented in previous test groups or only after years of use.
- There is no single right answer on whether or not to use hormone therapy. Each individual needs to talk to their doctor about their own personal risk-to-benefit ratio – to decide if a drug's advantages outweigh the possibility of adverse side effects.
- Hormone therapy is the most effective FDA approved medicine for relief of hot flashes, night sweats or vaginal dryness.
- Healthy women between 50 and 59 and those who begin HRT less than 10 years after starting menopause may not be at increased risk for heart disease or impaired cognition.
- Treatment for menopausal symptoms should start with the lowest effective dose.
- Women who use HRT for two to five years are less likely to be at an increased risk for breast cancer in the short term (long-term risk is still unknown).
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