Hot flashes, night sweats, vaginal dryness, and painful sex are some ways menopause can affect your life. As an OB-GYN, my patients often ask if menopausal hormone therapy (MHT) can help with these symptoms. There are different ways to treat menopause, including MHT.
What is MHT?
MHT is a prescription that can ease some menopause symptoms. It provides hormones—usually estrogen and sometimes progesterone—that your body stops making during menopause. But, like any treatment, it's important to know the risks and benefits before deciding if MHT is right for you.
The FDA has approved MHT for treating hot flashes and vaginal dryness. While some patients also hope it may improve symptoms like brain fog, sleep issues, low sex drive, joint pain, mood swings, and heart palpitations, these uses are not FDA-approved. However, there is some evidence that MHT could benefit certain individuals in managing these additional symptoms.
Discuss risks and benefits with your doctor
In 2002, a study called the Women’s Health Initiative (WHI) linked combined estrogen-progesterone therapy to risks like heart disease, stroke, blood clots, and breast cancer. Because of this, many people avoided MHT, even though it might have been safe for them. Since then, we’ve learned that MHT can be safe for the right patients. The risks of MHT depend on several factors, including:
- How the hormones are given: The WHI study showed an increased risk of heart issues with hormone pills, but we’ve found that this risk doesn’t apply to hormone patches.
- Formulation: The WHI study linked MHT to breast cancer risk, but it may have been the type of progesterone used. People with a uterus need some form of progesterone to protect against endometrial cancer, but options like bioidentical progesterone may not raise breast cancer risk the same way.
- Health history: For people with a history of stroke, heart attack, blood clots, or hormone-related cancer, the risks of MHT may outweigh the benefits.
- Age and time since menopause: The longer it’s been since your last period, the greater the risks from hormone use. MHT may be safer for people younger than 60 who have been in menopause for less than 10 years.
Since everyone’s health is different, it’s important to talk to your doctor to find the best option for you.
If you can’t or don’t want to take MHT
If MHT isn’t an option, there are other treatments. For hot flashes, FDA-approved non-hormonal options include low-dose paroxetine (Brisdelle), as well as other antidepressants like fluoxetine and sertraline. In 2023, the FDA approved Veozah, a drug that helps control body temperature to reduce hot flashes.
For painful sex, FDA-approved non-hormonal treatments such as ospemifene and DHEA may help. Additionally, over-the-counter vaginal moisturizers can be effective for mild to moderate symptoms.
Some people try alternative treatments for menopause, like herbal supplements or compounded bioidentical hormones. However, these products aren’t well-studied or FDA-regulated. It's best to talk to your doctor before trying them.
Other causes of menopause symptoms
Menopause symptoms like trouble sleeping or joint pain might be related to other issues, such as stress or an injury. Some medical conditions, like thyroid disorders, can also cause symptoms similar to menopause. That’s why it’s important to talk to your doctor about all your symptoms to get the best care.
Get help for menopause
The experts at Temple Health can help you decide if MHT is right for you. Schedule an appointment online or call 800-TEMPLE-MED (800-836-7536).
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