Combined HRT comes in many forms – pills that are taken orally, adhesive skin patches that are placed on your stomach, chest (not breasts), back, upper arm or buttocks, implants, and skin gels. Vaginal creams, suppositories, and vaginal rings, which are applied or inserted into your vagina are very effective if you have problems such as vaginal dryness. All these different forms are also available in many different combinations of estrogen and progesterone and in different strengths. So if one type of HRT doesn't seem to agree with you, you can try another. There is truly no "one size fits all" for this type of therapy.
There are many benefits, but also some side effects, when taking HRT, so you should discuss these with your doctor before you start the therapy. The benefits include the following:
• Relief from hot flushes and night sweats
• Relief from vaginal dryness
• Improved quality of sleep
• Potential delay in the onset of Alzheimer’s disease
• Protection against osteoporosis
• Reduced risk of colon cancer.
You may also suffer from some of the side effects when taking HRT and these include:
• Tender breasts
• Heavier periods
• Water retention
• Weight gain
• Depression
• Irritability.
Taking HRT in the long term is also associated with certain medical conditions; these include the following:
• Breast cancer
• Cancer of the lining of the uterus and ovaries
• Deep vein thrombosis
• Heart disease
• Gallstones
• Stroke
If you do decide to take HRT then you will need to see your doctor for regular check-ups to make sure there are no problems and side effects.
Vaginal therapy: If you only have problems with vaginal dryness, topical lubricants and moisturizers are readily available over the counter. However, for many women these really aren’t sufficient to relieve dryness and pain with intercourse, so vaginal estrogen creams, suppositories, and rings are available by prescription. The amount of estrogen absorbed from vaginal tablets and rings is minuscule; most oncologists will allow their breast cancer patients to use vaginal estrogens for moisture. If you use HRT patches or oral tablets, you may need to supplement them with vaginal therapy.
Antidepressants: These may be prescribed for women who prefer not to take hormonal therapy, but for whom natural self-help remedies don't work.
Commonly used antidepressants include drugs known as selective serotonin reuptake inhibitors (SSRIs) and serotonergic noradrenergic reuptake inhibitors, both of which can be helpful in relieving menopausal symptoms. Women who have had breast cancer, and for whom treatment with estrogen is not appropriate, may find significant relief with these medications.
However, the exact role of these drugs on menopause has yet to be clarified and they are not FDA-approved for this indication.
Page 3 of 5 – on the next page: how you can help yourself get through menopause!
Excerpted from Women's Health For Life, copyright 2009 Donnica Moore, MD and DK Publishing. Used by permission of DK Publishing.All Rights Reserved. No part of this excerpt may be reproduced except with permission in writing from the publisher.
