Understanding Menopause in Women and Exploring Hormone Replacement Therapy and Other Alternative Treatments
As a woman, no matter what you do, you can not escape menopause. This natural process will eventually happen no matter how healthy you are or how much effort you put into your exercise routine and diet. Every single woman will be affected by hormonal changes. She will experience, to a greater or lesser degree, some of the following symptoms: hot flashes, vaginal dryness, sleep disturbances, mood swings, weight gain, and muscle loss.
Hormone replacement therapy is a standard treatment that can be applied to improve the well-being of women and alleviate the symptoms of menopause. However, it is essential to consult with a healthcare professional to make an informed decision and also find out about some of the alternative approaches available, including different medications and lifestyle modifications that can help you alleviate the symptoms of menopause.
Definition of menopause and average age range when it occurs in women.
Menopause is a natural process. It is a biological process that marks the end of a woman's reproductive years. It is scientifically defined as the permanent cessation of menstrual periods, meaning the end of fertility. It is a part of the natural aging process and is thought to happen due to the ovaries gradually producing lower amounts of hormones, such as estrogen. The average age range when menopause occurs is between 45-55 years old. However, it can happen earlier or later than this age range.
When is menopause diagnosed?
Before entering menopause, women go through a phase called perimenopause or, in simple terms transitional phase. During the transitional phase, the menstrual cycle becomes irregular, and you might already experience some menopausal symptoms. After 12 consecutive months of no menstrual periods is when menopause is diagnosed.
Common symptoms experienced during menopause
hot flashes,
night sweats,
sleep disturbances,
weight gain,
muscle loss,
vaginal dryness,
mood changes,
increased anxiety,
and changes in libido.
Understanding Hormone Replacement Therapy (HRT):
HRT is a readily available treatment option used to manage menopause symptoms which not many women know about. Quite often, even if they do, they do not have time to consult and discuss with their doctor, so I wanted to write an in-depth article on this topic. This blog will help women have the basic knowledge and, more importantly, learn what questions to ask if and when they discuss hormone replacement therapy with their doctor.
HRT involves hormone therapy in which you take exogenous hormones, such as estrogen and Progesterone, to replace the declining levels of these hormones in your body. As we already mentioned earlier, in the pre-menopausal period and during menopause, you have a decline in the natural production of estrogen and Progesterone, and that's why taking those hormones exogenously can help you keep your body in balance.
Let's explore HRT and its purpose in managing menopausal symptoms
Estrogen and Progesterone
Estrogen is essential for maintaining bone health and helps keep your skin and vaginal tissue healthy. With age, the natural production of estrogen and progesterone declines. These two hormones are responsible for many functions in a woman's body! Estrogen primarily controls the reproductive cycle, whereas Progesterone works with estrogen to prepare the uterus for a potential pregnancy.
The dosage and frequency of estrogen and Progesterone will depend on factors like your current hormone levels, age, symptoms you are experiencing, and whether you have an intact uterus.
Women with an intact uterus will usually be prescribed estrogen and progesterone, while women with a hysterectomy will only be prescribed estrogen.
A brief overview of the role of estrogen in a woman's body
Reproductive system
Estrogen is essential for regulating the menstrual cycle in women. It also supports the development of secondary sexual characteristics in women and maintains the health of the uterus and vaginal tissues.
Bones
Estrogen supports the maintenance of bone density and prevents bone loss.
Brain and mood regulation
Estrogen has a powerful effect on your neurotransmitters and supports mood, memory, and cognition.
Cardiovascular system
Estrogen helps you maintain a healthy cardiovascular system by protecting your blood vessels.
The target estrogen values in your body can not be limited to one number as the hormone levels constantly change. It is essential to look at hormones and the symptoms the body is experiencing.
Regarding HRT, the starting dosage typically ranges from 0.3 to 1.0 milligrams of oral estradiol or an equivalent dose of other estrogen formulations daily.
Transdermal patches may start at doses ranging from 0.025 to 0.05 mg daily.
Vaginal estrogen creams or rings usually have lower doses and are primarily used to relieve women of vaginal symptoms.
Important note: the objective is not to hit a specific number when it comes to estrogen values but rather to alleviate the menopausal symptoms and support overall health and well-being while minimizing your risks
A brief overview of the role of Progesterone in the woman's body!
One of the primary roles of Progesterone is to protect the lining of the uterus (endometrium) and prevent excessive growth that can result in endometrial cancer. Progesterone also plays an essential role in the development of healthy breast tissue.
Important note: The synthetic version of Progesterone is called progestin. It is most often prescribed together with estrogen for women on hormone replacement therapy that have an intact uterus.
What does an intact uterus mean?
An intact uterus means that the uterus has not been surgically removed. The uterus will be released in situations like severe endometriosis or uterine cancer, and in those cases, the woman will be prescribed estrogen-only HRT.
In hormone therapy, there is no black-and-white approach; amongst different healthcare professionals, you will have different approaches to hormone replacement therapy. Like estrogen, the dosages for Progesterone or progestin will vary depending on a woman's needs, current values, symptoms, and, most notably, the patient's response to the treatment. It also depends on their doctor's approach and experience working with women.
The dosage of Progesterone or progestin can vary depending on the specific hormone therapy regimen and individual needs.
The ranges for Progesterone or progestin may range from 1.5 to 10mg per day. They could be taken cyclically or continuously, depending on what the doctor believes is the best way forward.
Forms of Hormone Replacement Therapy
HRT can be administered in various forms, including:
Oral tablets or pills
These can be taken daily and combined with estrogen and progestin or contain each hormone separately.
Transdermal patches
Patches are applied to the skin and release hormones gradually into the bloodstream.
Topical creams, gels, or sprays
Creams, gels, or sprays are applied to the skin and are mainly used to relieve local symptoms like vaginal dryness.
Vaginal rings
Vaginal rings are inserted into the vagina and continuously release a low estrogen dose within that localized area.
Some risks and considerations related to hormone treatments in menopausal women
As mentioned, estrogen therapy or a combination of exogenously administered estrogen and Progesterone can effectively treat menopausal symptoms in women. However, it is crucial to understand the potential risk and individual health factors.
Women with an intact uterus should be highly cautious of taking estrogen alone as it increases the risk of endometrial cancer. Long-term hormone treatment might carry other potential dangers like increased blood clot risk, stroke, and breast cancer.
When deciding to start estrogen therapy or any other hormone therapy, you should consult a healthcare provider and thoroughly weigh the benefits and risks of such treatment.
Non-hormonal medications that women use to alleviate symptoms of menopause
SSRIs and SNRIs
These drugs are antidepressant medications that can help women reduce hot flashes and improve mood during menopause.
Gabapentin and pregabalin
Even though these drugs are primarily used to treat seizures in epilepsy and certain types of nerve pain, they are commonly prescribed off-label to help reduce hot flashes in women with menopausal symptoms. The mechanism by which they work is not entirely understood, but they are believed to do it by regulating nerve activity and neurotransmitter levels.
Clonidine
Clonidine is primarily used for high blood pressure and can alleviate hot flashes.
Phytoestrogens
Phytoestrogens are estrogen-like compounds in plant-based foods like soy, flaxseeds, and tofu. They are believed to help reduce hot flashes in women during menopause, but no concrete evidence backs this up.
Lifestyle modifications can help women's health and reduce symptoms of menopause.
exercise
healthy diet
meditation and breathing techniques
To learn more about menopause in women, check out the website of the North American menopause society or read our comprehensive blog: Menopause in Women: Signs, Symptoms & Course of Action to Prolong and Alleviate Those Symptoms
Conclusion
Menopause can sometimes carry mild symptoms, while in some cases, women can experience ever menopause symptoms which can dramatically reduce a women's quality of life. That's why it is essential to know what options are readily available to alleviate the symptoms of menopause and give the support needed to go through this period of a woman's life. If you need help and support during this period, do not hesitate to contact us, as we would be delighted to guide and support you on this journey! I hope this article provided some helpful information that will help you get more informed so that you can, in conjunction with your healthcare provider, make the best assessment of the benefits and health risks involved in hormone therapy and other methods to treat menopause.
Resources that helped me write this article:
North American Menopause Society (NAMS): https://www.menopause.org/
Mayo Clinic - Article on Menopause: https://www.mayoclinic.org/diseases-conditions/menopause/symptoms-causes/syc-20353397
WebMD - Menopause Health Center: https://www.webmd.com/menopause/default.htm
National Institute on Aging - Article on Menopause and Hormone Therapy: https://www.nia.nih.gov/health/menopause
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