Hormone Therapy for Menopause

Benefits of Hormone Therapy

When HT is used safely and under a physician’s guidance, it can ease menopause symptoms and support long-term health. Estrogen replacement restores balance in the body and improves daily comfort, mood and overall quality of life.

Hormone therapy can:

• Reduce hot flashes and night sweats
• Ease vaginal dryness and irritation
• Boost mood and focus
• Improve sleep
• Protect bone strength
• Promote urinary and vaginal health

According to The Menopause Society, hormone therapy offers the most effective relief for hot flashes and night sweats and also reduces bone loss and lowers fracture risk.

Who Can Benefit from Hormone Therapy?

Menopause affects every woman differently. For some, the transition brings only mild changes. For others, they face symptoms that affect work, relationships and rest. HT may offer relief when symptoms interfere with daily life. It may be a good fit if you have:

• Frequent hot flashes or sudden warmth
• Vaginal dryness or pain during intimacy
• Low energy or consistent feelings of tiredness
• Night sweats that cause sleep disruption
• Mood changes or irritability
• Early signs of bone loss or higher risk of osteoporosis

Healthy women who start HT before age 60 or within 10 years of menopause often experience the most benefit. Many feel better within a few weeks of starting treatment.

Who Should Avoid Hormone Therapy

HT is not for everyone. Your physician will review your health and family history to decide if it is safe for you. You may need to avoid it or use caution if you have:

• A history of breast, ovarian or uterine cancer
• Blood clots, stroke or heart disease
• Liver disease
• Unexplained vaginal bleeding

Because hormones can affect how blood clots, how your body processes cholesterol and how some tissues grow, it is important to talk with a physician before starting therapy. If hormone therapy is not a good fit, your physician can recommend other ways to manage symptoms, protect your bones and support overall wellness.

Types of Hormone Therapy

There are different forms of HT, depending on your symptoms and health needs. Each option works differently in the body and offers unique benefits.

Systemic therapy: Pills, skin patches, gels or sprays circulate estrogen throughout your bloodstream. This type of therapy treats whole-body symptoms, such as hot flashes and night sweats.

Local therapy: Vaginal creams, tablets or flexible rings release a small amount of estrogen directly to vaginal tissue. These products relieve dryness and discomfort and absorb less hormones in the bloodstream.

If you still have a uterus, you will usually take estrogen plus progestin to protect the uterine lining. If you have had a hysterectomy, estrogen alone may be sufficient, according to the American College of Obstetricians & Gynecologists.

Your physician will explain how each form works, review the safety information and help you decide which treatment fits your medical history and goals.

Risks and Side Effects

Every medical treatment carries some risk. For most healthy women, the benefits of hormone therapy often outweigh the risks. However, starting treatment after age 60 or more than 10 years after menopause may increase the risk of heart disease, stroke, blood clots or dementia.

The risks of hormone therapy will differ depending on the type, dose, duration of use, method of administration, timing and whether it includes a progestin. Treatment should be individualized and reviewed regularly.

Possible risks and side effects may include:

• A small increase in breast cancer risk with long-term combination therapy (estrogen and progestin)
• A higher chance of blood clots or stroke, especially with oral estrogen
• Temporary side effects such as breast tenderness, bloating or nausea

Using the lowest effective dose for the shortest time helps reduce risks. Patches or low-dose options may also lower the risk of clots compared with pills, according to the American College of Obstetricians & Gynecologists (ACOG).

“With regular checkups, hormone therapy can be a safe and effective tool for many women,” said Dr. Sheridan-Kelchner.

Alternatives to Hormone Therapy

If hormone therapy is not right for you, you still have options which may include:

• Nonhormonal medications — Certain antidepressants or anti-seizure medications reduce hot flashes.
• Lifestyle changes — Eat well, stay active, avoid smoking and limit alcohol.
• Vaginal moisturizers and lubricants — Relieve dryness and discomfort.
• Mind-body approaches — Deep breathing, yoga and mindfulness may reduce stress and improve sleep.

Monitoring and Ongoing Care

Regular follow-up care will ensure your treatment remains safe and effective. Your physician will check your blood pressure, breast health and overall progress every 6–12 months. If you experience new or unusual symptoms, talk to your health care team.

If menopause symptoms affect your daily life, do not wait to ask for help. Your physician can explain your options and create a plan that fits your health goals. “Menopause does not mean you have to live with discomfort,” said Dr. Sheridan-Kelchner. “There are safe and effective treatments to help you stay healthy and feel good.”

Catholic Health’s Women’s Health specialists offer compassionate, personalized care to help you manage symptoms and protect your long-term health.