The need for professional help with menopausal symptoms is great. Nearly three-quarters of affected women visit a gynecologist for this reason. The number of visits increases continuously with both the variety and intensity of the complaints. Hormone therapy is a common measure to alleviate menopausal symptoms. We inform you about benefits and side effects here.
Non-drug measures for menopausal symptoms
An integral part of a treatment for menopausal symptoms are the so-called non-drug measures. These include:
- Switching to a healthy diet with little caffeine, alcohol and nicotine.
- Stress avoidance and more exercise
- Conscious relaxation, for example, with yoga, acupuncture, etc.
These measures also serve to maintain health and well-being for a long time.
Hormone therapy during menopause
If in the first place the decreasing hormone production in the menopause is responsible for the physical and mental discomfort, it seems reasonable and logical to replace these missing hormones, thus combating troublesome symptoms through hormone administration.
Combination preparations with an estrogen and a progestin component are predominantly used. Today, pure estrogen preparations are generally only prescribed for women who have had their uterus surgically removed. To individualize therapy, consideration should first be given to which phase of menopause the woman is in.
When is hormone replacement therapy used?
Study results from the United States and the discussion sparked by them in the media about the relationship between the benefits and risks of hormone replacement therapy have prompted the German Federal Institute for Drugs and Medical Devices (BfArM) to publish the following areas of use and conditions of use for hormone replacement therapy with estrogen-progestin combinations:
- For menopausal symptoms: only in cases of pronounced individual distress, only after exclusion of risk factors (cardiovascular disease, venous thromboembolic complications, cancer) and after informing the patient about the possible risks; duration of use as short as possible (for example, 1 to 2 years and, if necessary, discontinuation attempts); the estrogen dose is to be chosen as low as possible.
- For the prevention of osteoporosis, estrogen-progestin combinations should be discontinued in postmenopausal women; for women at increased risk of osteoporosis, other available options should be considered as alternatives.
- For urinary and genital regression symptoms: consider topical (applied to the skin) medications such as patches or gels.
On the subject of protective function for the cardiovascular system, the BfArM states that the prevention of cardiovascular disease is not one of the approved indications for the estrogen-progestin combinations commonly used in Germany. Based on the current data, treatment for the purpose of prevention was not justified, it said.
Side effects of hormone therapy
Possible side effects of hormone therapy include:
- Thrombosis
- Weight gain
- High blood pressure
- An increased risk of uterine or breast cancer (only with estrogen alone in women whose uterus is still present).
- Skin reactions
- Breast tensions
- Headache
- Dizziness
- Liver dysfunction
- Gastrointestinal complaints
When is hormone therapy inappropriate?
Important contraindications to hormone replacement therapy include:
- Severe liver disease
- An increased risk of thrombosis and previous or existing thromboses or embolisms
- Estrogen-dependent tumors
- Endometriosis
- Diabetes mellitus with manifest vascular damage
- A difficult to adjust high blood pressure
