You’ve probably heard that some people treat the symptoms of menopause with hormone therapy (MHT). MHT can help with the changes that come with lower levels of estrogen at menopause, especially hot flashes, sleep problems, vaginal dryness, and bone loss (osteoporosis).
The nuts and bolts of using MHT
MHT is prescribed by a healthcare provider. Your provider will help you determine the right type of hormones, along with the best way for you to take MHT.
There are two main types of MHT:
- Estrogen-only therapy (ET) is prescribed to women who’ve had a hysterectomy.
- Estrogen plus progesterone therapy (EPT) is prescribed to women who have a uterus. Progesterone protects the uterine lining, lowering the risk of uterine cancer.
There are two ways to take MHT:
- Systemic MHT travels through your bloodstream to all the parts of your body. You can take systemic MHT as an oral tablet, patch, gel, emulsion (a cream or lotion), spray, or injection.
- Low dose MHT works specifically in the vagina. Low dose MHT medications come in creams, rings, or tablets.
What to know about the benefits and risks of MHT
There’s a lot of confusing information out there about MHT, so let’s dig into the facts. There are hundreds of clinical studies to show that systemic MHT is effective at easing hot flashes, vaginal dryness, and night sweats, and preventing bone loss. People who’ve used MHT report better sleep, sex life benefits, and overall improvements to their quality of life.
MHT got a lot of negative attention in 2002 when a long-term study, called the Women’s Health Initiative (WHI), showed that post-menopausal women using MHT had increased risks of breast cancer, heart disease, stroke, blood clots, and urinary incontinence.
It’s important to know that the early WHI findings included post-menopausal women across a wide range of ages. As researchers broke down the data, they discovered that younger women (those in their 50s, as opposed to women in their 70s) were far less likely to have health complications, and that shorter-term use of hormones (about three to five years) reduces risks.
Further research showed that women with early menopause (before 40), and no history of breast cancer or other risk factors, have low risks from taking MHT until the typical age of menopause (51). Women without a uterus who take estrogen alone also have lower risks, especially if they are younger.
All of this research has shaped how healthcare providers prescribe MHT, so they can maximize the benefits and keep risks low. Healthcare providers now consider the age of the patient and when they went through menopause, and the severity of symptoms. Providers will prescribe the lowest effective dose of MHT, and make a plan for patients to take MHT for only a few years.
Reviewed by the Ovia Health Clinical Team
Sources
- The North American Menopause Society: https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/hormone-therapy-benefits-risks (accessed 11/30/21).
- Office on Women’s Health (US Department of Health and Human Services): https://www.womenshealth.gov/30-achievements/25
- Manson, JoAnn E. et al. JAMA Network:
- https://jamanetwork.com/journals/jama/fullarticle/1745676
