menopause Can lead many hosts Destructive symptoms Like hot flashes, night sweats, sleep problems. Hormonal therapy promises relief.
But many women are wondering about taking it. It is a recent panel of experts convened by the treatments that are subject to Food and Drug Administrationhas been surrounded by uncertainty for a long time.
It was once used on a daily basis. However, in 2002, one type of study was stopped early due to concerns about increased risk of breast cancer and blood clots. Concerns remained despite later studies showing that the benefits of today’s hormone therapy outweigh the risks of many women.
“There’s still a lot of confusion and a lot of fear,” said Grayson Rebellenz, 50, from Durham, North Carolina.
Others are also increasingly seeing hormonal therapy again. However, experts continue to agree on how to present the advantages and disadvantages of treatment. The panel assembled by the FDA highlighted the benefits and suggested removing health warnings from at least some versions.
Doctors say hormone therapy is a great option for many menopause women. And it is important to understand the subtle realities of these treatments before deciding what is best.
How hormone therapy works
It treats symptoms that can occur once menstruation is over and over, resulting in a very low level of estrogen and progesterone.
One type is low-dose vaginal estrogen therapy. Because it is applied to the vagina, there is little circulation in the blood and the risk is much lower. Doctors say it’s a good option for women whose biggest complaint is dry vaginal.
Systemic therapy includes pills, patches, sprays, gels, or vaginal rings that provide large amounts of hormones into the bloodstream at such high levels that they can significantly affect symptoms such as hot flashes. These whole body hormones include estrogens and progestogens.
Jennifer Zwink, a nurse in Castle Rock, Colorado, began using estrogen patches over a year ago and also has an IUD that gives progesterone. The treatment eased her hot flashes, improved sleep, and relieves pain and bloating in her joints.
“It’s not like a 100% magic wand,” she said. “But it definitely made a huge difference.”
The Menopause Society says hormone therapy can reduce the risk of cardiovascular disease if it begins within 10 years of reaching menopause. It also reduces the risk of type 2 diabetes and may maintain bone density for longer.
“They may have lower bone density at age 60 rather than 50,” said Dr. Margeva Morris Cole, an alumnus at Duke University.
Hormonal therapy has several risks
When Leberentz was first prescribed hormone therapy last year, she continued to worry about the risks she had heard. And finally, I decided, “I can’t live like this anymore.”
The combination of three medications lifted her anxiety, improved her sleep, and eliminated joint pain and hot flashes.
“I feel like I am again,” she said.
Doctors hesitate to try many patients and try to reassure them.
According to the Menopause Society, women can use estrogen therapy for seven years and estrogen-tumor therapy for three to five years before their risk of breast cancer increases.
The group says both estrogen therapy and estrogen-symptom therapy increase the risk of stroke that disappears shortly after the hormone is stopped. Taking hormones in the mouth increases the risk of blood clots, but using patches, gels, or sprays can reduce them.
“Many of these risks are small,” said Dr. Nanette Santoro, an alumnus at the University of Colorado. “And they must be pressured against the interests of symptom relief.”
Age, medical history, and the length of time a woman will be staying in the hormones are also considerations. Many women have taken them for about five years, and those suffering from stroke or other specific conditions may be advised to use them.
Discussions regarding changes in hormonal drug warnings
Doctors are split on whether there should be changes in the “black box” health warnings in some hormonal treatments. All estrogen drugs still have boxed warnings about high strokes, blood clots and cognitive problems among women taking the medication.
Most doctors on the recent FDA-convened panel of experts have been involved in pharmaceutical industry campaigns that prescribe hormones or oppose warning labels. The letter, signed by 76 doctors and researchers, claiming that “removing label warnings without proper scientific assessments will put patients at risk,” and asked to hold a hearing and advisory committee meeting before making any changes.
In the meantime, doctors urge people to be wary of misinformation, like the false claims in social media posts that hormones prevent dementia and ensure healthy old age.
“I can’t say you’re going to live a longer, healthier life because you’re taking hormones,” Duke’s Cole said. “I don’t want to go to the pendulum until now, so people feel it’s a promise of health for the next 30-40 years.”
Alternatives to hormone therapy for menopause
Santoro pointed out a new non-hormonal drug called fezoline, which is sold as Veza, due to hot flashes and night sweats. The low-dose antiepileptic drug gabapentin can also be used for hot flashes, and moisturizers can improve vaginal dryness.
Experts also say regular exercise and a healthy diet can help you manage your symptoms.
Santoro urged the “wild proliferation” of supplements that it claims to be menopause treatment.
“Everyone is taking part in the menopause gold rush,” she said. “If it looks too good and isn’t true, it probably is.”
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