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What About Hormone Replacement?
In perimenopause, your doctor might suggest birth control pills as a menopause treatment especially if you are having problems with very heavy, frequent or unpredictable menstrual periods. This medication will make your periods more regular. It may also help with symptoms like hot flashes. However, birth control pills can hide the arrival of menopause. If you think you might have reached menopause, you can stop taking the pill for a while and see if you start having regular periods again. But if you were using birth control pills to prevent pregnancy, you should remember to use another type of contraceptive until you have gone 12 months without a period.
In menopause, your doctor might suggest taking estrogen and progesterone, known as hormone replacement therapy or HRT as menopause treatment. Hormone replacement therapy involves taking estrogen plus progestin. Estrogen alone, or ERT, is for women who have had the uterus removed. Estrogen plus progestin is for women with a uterus. Progestin, when used with estrogen, helps reduce the risk of uterine cancer. These hormones can be taken in a variety of forms such as pills, skin patches, creams, or vaginal inserts, depending on a woman's needs.
Hormone replacement therapy HRT or ERT may relieve menopause-related symptoms, such as hot flashes, and reduce loss of bone. However, Hormone replacement therapy has risks. It should not be used for long-term prevention of heart disease. Taking hormone replacement therapy increases, rather than reduces, the risk for heart disease and stroke. It also increases the risk of breast cancer and blood clots. But it appears to decrease the risk of colon cancer. Scientists are still studying the effects of hormone replacement therapy - the final answers are not yet available. Talk to your doctor about taking estrogen/progestin or about other treatments (for example, biofeedback) that may ease menopausal symptoms.
What About Phytoestrogens?
Phytoestrogens are estrogen-like substances found in cereals, vegetables, legumes (beans), and some herbs. They may work in the body like a weak form of estrogen. Some may lower cholesterol levels. Soy, wild yams, and herbs such as black cohosh and dong quai, contain phytoestrogens and may relieve some symptoms of menopause. The government does not regulate phytoestrogens. Scientists are studying some of these plant estrogens to find out if they really work and are safe as menopause treatment.
Be sure to tell your doctor if you decide to eat more foods with phytoestrogens as menopause treatment. Any food or over-the-counter product that you use for its drug-like effects could interact with other prescribed drugs or cause an overdose.
How Do I Decide What to Do?
Talk to your doctor to decide how to best manage your menopause. Think about your symptoms and how much they bother you. You also need to consider your medical history - your risk of heart disease, osteoporosis, and breast cancer. Remember that your decisions are never final. You can, and should, review them with your doctor every year during your checkup. You can see a gynecologist, geriatrician, general practitioner, or internist.
For your grandmother and great-grandmother, life expectancy was shorter. Reaching menopause often meant that their life was nearing an end. But this is no longer true. Today women are living longer - on average, until age 78. By making wise decisions about menopause and a healthy lifestyle, you can make the most of the 20, 30, or more years you have ahead!
How Can I Stay Healthy Throughout Menopause?
- Don't smoke.
- Eat a healthy diet that is low in fat and cholesterol and moderate in total fat. Your diet should aim to be high in fiber and include fruits, vegetables, and whole-grain foods. It should also be well balanced in vitamins and minerals, including calcium.
- Lose weight if you are overweight.
- Take part in weight-bearing exercise, such as walking, jogging, running, or dancing, at least 3 days each week.
- Take medicine to lower your blood pressure if your doctor prescribes it for you.
- For vaginal discomfort, use a water-based vaginal lubricant (not petroleum jelly) or an estrogen cream.
- If you frequently feel an urgent need to urinate, ask your doctor about techniques such as pelvic muscle exercises, biofeedback, and bladder training that can help you improve muscle control.
- Be sure to get regular pelvic and breast exams, Pap tests, and mammograms. Contact your doctor right away if you notice a lump in your breast.
- If you are having hot flashes, keep a diary to track when they happen. You may be able to use this information to help find out what triggers them.
Try these tips to help manage hot flashes:
- When a hot flash starts, go somewhere cool.
- If hot flashes wake you at night, try sleeping in a cool room.
- Dress in layers that you can take off if you get too warm.
- Use sheets and clothing that let your skin "breathe."
- Have a cold drink (water or juice) at the beginning of a flash.
National Institute on Aging
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