estrogen therapy for menopause

Managing Symptoms of Menopause

Estrogen Therapy for Menopause Can Help Ease Symptoms

Menopause is a natural part of life but can come with some unwanted symptoms: mood changes to hot flashes, vaginal dryness and more. If you’re looking for an effective treatment for symptoms of menopause, hormone replacement therapy might be the right one for you, or consider Myfembree, a medication used for the management of heavy menstrual bleeding associated with uterine fibroids in premenopausal women.

10 Signs of Menopause at 40

Some of the most common menopausal signs and symptoms include:

  1. Hot flashes and/or blushing (these symptoms are also called vasomotor symptoms due to their impact on blood vessels).
  2. Night sweats or cold flashes.
  3. Changes to your period.
  4. More frequent periods.
  5. Periods that last longer than a week.
  6. Heavy bleeding.
  7. Spotting between periods.
  8. It’s always worth checking with your doctor if these symptoms become debilitating.
  9. Physiological changes.
  10. Muscle loss and/or fat gain.

Some other symptoms include:

  • Weight gain around the midsection.
  • Thinning skin.
  • Vaginal dryness.
  • Tender breasts.
  • Difficulty sleeping and/or insomnia.
  • Mood changes.
  • Irritability.
  • Mild depression.
  • Mood swings.
  • Painful sex.
  • Changes in sex drive.
  • Headaches.
  • Muscle and joint aches.
  • Temporary issues with concentration or memory.
  • Racing heart.

It's important to remember that not everyone is going to experience every single one of these symptoms. Some people may breeze through their transition with ease, while it can be a little more frustrating or uncomfortable for others. Fortunately, hormone replacement therapy can provide a lot of relief during this transitional phase.

What is Menopause?

While menopause is often poorly represented in Western culture, it’s important to remember that it is a natural part of the aging process, not a disease or disorder to be treated. Symptoms of menopause can be frustrating and negatively impact daily life, but that doesn’t mean this condition should be overly pathologized.

While we may think of menopause as the many years leading up to our last period in which people who menstruate go through a variety of hormonal changes, it is defined as the day on which you have gone 12 months without your monthly period. Those phases leading up to and following menopause are typically called the menopausal transition/perimenopause and post-menopausal phases respectively.

During the years preceding your final period, the ovaries start to decrease estrogen production leading to the end of your menstrual cycle. At this point, the adrenal glands take over the production of estrogen. This change leads to a body-wide reduction in estrogen and other shifts in hormones that can cause menopausal symptoms.

The period leading up to your final cycle, called perimenopause, can start as early as your mid-thirties and lasts until that day when you have not had a menstrual cycle for 12 months. The length of time varies by person, with some people experiencing perimenopause for five years and others for whom it can last up to 14 years.

After menopause, you enter the phase called postmenopause. Those in this life phase are more vulnerable to osteoporosis, sarcopenia and heart disease. Hormone replacement therapy can help support health during the premenopausal and postmenopausal stages.

What is Hormone Replacement Therapy?

Hormone replacement therapy, specifically estrogen therapy, is the use of synthetic estrogen to help reduce menopausal symptoms. There are many ways to add estrogen to the body, including:

  • Skin patches: worn below the waist and replaced once or twice weekly.
  • Vaginal suppositories: often prescribed or recommended to women who are experiencing vaginal dryness or pain during intercourse.
  • Estrogen Pills: the most common form of ERT is a pill taken once a day.
  • Topical creams, gels or sprays are applied to the skin and absorbed directly into the bloodstream.

You will want to talk with your primary care provider to determine which dose and form is best for your specific needs. Doctors typically want you to be on the lowest dose possible to alleviate symptoms. Symptom relief often happens quickly once estrogen replacement therapy is started.

What are the Benefits and drawbacks of Estrogen Therapy?

The main benefit of hormone replacement therapy (HRT) is that it can provide effective treatment of the menopausal symptoms listed above, such as night sweats, hot flashes, vaginal dryness and painful intercourse. Some other benefits of HRT include:

  • Improved feelings of well-being and overall mood.
  • Decreased risk of diabetes.
  • Decreased risk of osteoporosis.
  • Decreased risk of colon cancer.
  • May slightly improve joint pain.
  • Overall lower death rate for women in their 50s.

Some of the risks associated with HRT can include:

  • Possible increased risk of developing breast cancer with long-term use.
  • Increased risk of gallbladder issues, including gallstones.
  • Increases risk of dementia if started after midlife. However, if started during midlife, it can decrease the risk of Alzheimer’s disease and dementia
  • It may increase the risk of endometrial cancer in those who still have uteruses and are not combining their estrogen with progestin.
  • Increased risk of stroke and blood clots.

Some of these risks can be mitigated by taking an estrogen replacement therapy that is combined with progestin, specifically for those people who still have their uteruses.

As with any medication, there are contraindications so the following people should not take hormone replacement therapy:

  • Have liver disease.
  • Have a history of breast or endometrial cancer.
  • Have had blood clots or are at high risk of developing them.
  • If you are or suspect you are pregnant.
  • Have a history of heart attack or stroke.
  • At risk for vascular disease.
  • Experiencing abnormal vaginal bleeding.

There are pros and cons to hormone replacement therapy that seeks to balance estrogen levels. If you are experiencing frustrating or debilitating symptoms of menopause, talk to your healthcare provider to see if you are a candidate for HRT.

Estring for Menopause

Estring is a vaginal ring that offers relief to women experiencing menopausal symptoms. Composed of a flexible material containing estradiol, a type of estrogen, Estring is inserted into the vagina, where it gradually releases a low dose of hormone to address specific challenges of menopause, such as vaginal dryness and discomfort during intercourse. By providing localized estrogen therapy, Estring helps restore the natural balance of hormones in the vaginal area, alleviating symptoms and enhancing overall comfort for women navigating through the menopausal transition.

Myfembree for Premenopausal Women

Myfembree is a medication used for the management of heavy menstrual bleeding associated with uterine fibroids in premenopausal women. It is a combination tablet containing relugolix, estradiol, and norethindrone acetate. Relugolix is a gonadotropin-releasing hormone (GnRH) receptor antagonist that suppresses the production of estrogen and progesterone, hormones that can cause uterine fibroids to grow. Estradiol is a form of estrogen, and norethindrone acetate is a progestin. Together, these hormones work to reduce menstrual bleeding by regulating the menstrual cycle.

In Conclusion

Estrogen therapy stands as a crucial and effective intervention in the realm of menopausal management, providing women with a range of benefits that extend beyond the alleviation of symptoms. As we've explored, this therapy not only addresses the often challenging physical manifestations of menopause, such as hot flashes and vaginal dryness but also plays a significant role in safeguarding long-term health. By bolstering bone density, heart health and potentially cognitive function, estrogen therapy emerges as a comprehensive solution for many women navigating the intricate landscape of menopausal changes.

Read on to learn all about the best vitamins to help with menopause.