Julia Fountain ND, NCMP
Menopause Hormone Therapy (MHT) refers to hormones (estrogen and/or progesterone) prescribed to women to help alleviate symptoms associated with peri- and post-menopause.
The decision to use hormone therapy is dependent on assessing risk vs benefit. There is shared decision making between a woman and her prescribing clinician (MD, ND or Nurse Practitioner). Her personal risk factors, the extent of her symptoms, and her personal preferences about how she wants to experience the transition are all important factors in decision making.
The estrogen component of menopause hormone therapy provides most of the benefit during menopause. Yet, taking hormone therapy doesn’t relieve every symptom of menopause.
These are the primary indications for menopause hormone therapy:
- Relief from menopausal hot flashes and night sweats (collectively called vasomotor symptoms). Compared with placebo, MHT reduces frequency of these symptoms by 75%. No other treatment (naturopathic or otherwise) provides as reliable relief. This in turn, may improve sleep, fatigue, mood, ability to concentrate and overall quality of life.
- Relief from genitourinary symptoms of menopause (GSM) GSM symptoms include: genital dryness, burning and irritation, sexual symptoms of reduced lubrication and pain with sex; reduced sensation in vaginal tissues, urinary symptoms of urgency, painful urination and recurrent UTI’s. Hormone therapy for GSM can be systemic (hormone gels, patches or pills), or low dose local vaginal estrogen (creams or ovule suppositories).
- Menopause hormone therapy is also a well-established treatment to prevent bone loss, which taken over a period of years can help prevent abnormal fractures related to osteoporosis. However, hormone therapy is not a recommended treatment for established osteoporosis.
MHT has risks and benefits. The risks of menopause hormone therapy increase after five or more years of usage, after the age of 60 or if a woman is 10 years beyond menopause. A woman’s personal health history with regard to breast cancer, cardiovascular disease, blood clots, untreated hypertension, smoking and unexplained vaginal bleeding all need to be taken into consideration in assessing risk. The risk vs benefit ratio is revisited every year while a woman is on hormone therapy and is a driver in deciding when to discontinue prescription hormones.
If you have questions about menopause hormone therapy and if it’s right for you, please schedule an Initial Assessment and Consultation with Dr. Julia Fountain ND NCMP