Everything You Need to Know About Perimenopause

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Should You Try Hormone Therapy?

After you reach natural menopause, you might still experience symptoms such as hot flashes. If these are significantly interfering with your life, you can consider trying hormone therapy (HT), a combination of estrogen and a progestin or progesterone. You've probably heard about the potential risks (such as heart attack, stroke, and breast cancer), including the recent research showing that women who use hormone therapy have a slightly higher risk of getting invasive breast cancer and even dying from it. But these represent relatively small numbers overall.

Talk to your gynecologist about whether the benefits of alleviating symptoms justify the risks. According to most experts, HT appears to be safer if you start at the onset of menopause rather than starting it many years later (although a newer study may dispute this). Hot flashes can last 10 years or longer, and many women stay on HT for years or even decades. Most doctors say you should use the lowest dose that alleviates your symptoms for the shortest amount of time. You can try pills, patches, creams, gels, and sprays. The forms that are applied to the skin may be safer for some women because the estrogen goes straight to the bloodstream, bypassing the liver, which decreases the risk of blood clots.

You've probably also heard about bio-identical hormones. Some of these products are regulated by the FDA, which means they have to meet standards of safety and efficacy. Other bio-identical products made in compounding pharmacies are not approved by the FDA. So far there is no evidence that hormones from compounding pharmacies are either safer or more effective than other forms of hormone therapy.

Want more? Wingert and Kantrowitz wrote the book on hot flashes and mood swings -- literally (The Menopause Book). They'll answer your most burning questions at LHJ.com/hotflash.

Originally published in Ladies' Home Journal, April 2011.


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