Menopause - Medications

Medications

Hormone Replacement Therapy (HRT)

Hormone replacement therapy, also known as menopausal hormone therapy (MHT) or hormone therapy (HT), uses medications that contain the female hormones that the body has stopped producing after menopause. The primary reasons that women use HRT is for the relief of hot flashes, night sweats, and vaginal dryness.

Hormone replacement therapy uses either estrogen alone (known as estrogen therapy [ET]) or estrogen in combination with progestogen (known as EPT). (The term “progestogen” encompasses both progesterone and progestin. Progesterone is the name for the natural hormone that the body produces. Progestin refers to a synthetic hormone that has progesterone effects.)

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• Women who have a uterus (have not had a hysterectomy) receive estrogen plus progesterone or a progestin (EPT). Progestogen is added to estrogen to protect the uterine lining (endometrium) and reduce the risk of endometrial cancer.
• Women who do not have a uterus (have had a hysterectomy) receive estrogen alone (ET).

General Recommendations for HRT

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.
• HRT should not be used for longer than 5 to 7 years.
• Women who take HRT should have a low risk for stroke, heart disease, blood clots, and breast cancer

Initiating Therapy. Before starting HRT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for heart disease, stroke, blood clots, osteoporosis, and breast cancer. While taking HRT, you should have regular mammograms and pelvic exams and Pap smears.

Discontinuing Therapy. When a woman stops taking HRT, perimenopausal symptoms may recur. There is some debate about whether it is better to abruptly stop the medication or to taper it off gradually. Gradual discontinuation of HRT may delay -- but not prevent -- the reappearance of symptoms. However, when a woman reaches full menopause, symptoms will eventually go away.