How do I decide whether or not to take hormone therapy?
To decide whether hormone therapy is right for you, first talk to your doctor about your menopausal symptoms and how much they bother you. Your choice will ultimately be guided by how bothersome your symptoms are, your age, your other risk factors, what your treatment options are, and your personal preferences.
Although large studies like the Women's Health Initiative have taught us a lot about the risks and benefits of hormone therapy, there is still much we don't know. Each woman is unique, and in the end the decision on whether or not to take hormone therapy should be reached together with your doctor after weighing the possible risks and benefits. Although taking hormones for short periods at low doses is considered safer than longer-term hormone therapy, there is no amount that is considered completely safe.
Who should not take hormone therapy?
You should not take hormone therapy if you have:
- History of heart disease or stroke
- A history of blood clots
- Unusual vaginal bleeding
- A history of hormone-sensitive cancer (such as breast or uterine)
- Liver disease
- Or if you are pregnant or may become pregnant
How should I choose which type of hormone therapy to take?
Your choice of hormone therapy will depend on what your symptoms are, how severe they are, and personal preference. For example, in women whose main complaint is vaginal dryness, vaginal creams, gels or tablets may be the best choice because these products deliver the minimum amount of hormone where it's needed most. Women taking hormones to control hot flashes need a systemic hormone (one that is delivered to the whole body), so a pill may be better.
Research all your options and discuss them with your doctor to decide which type of hormone therapy is right for you. Regardless of what you decide, you should take the lowest dose that controls your symptoms for the shortest amount of time possible. With a doctor's guidance most women can try to wean off treatment within the first year. Women whose symptoms return can try to taper off again in 6 months.
What are the alternatives to hormone therapy?
For more information:
National Heart Lung and Blood Institute Facts about menopausal hormone therapy
List of Hormone Products for Postmenopausal Use in the United States and Canada
The North American Menopause Society
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