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Monday Medical: Stay cool through menopause

Susan Cunningham/For Steamboat Today
Monday Medical
MondayMedical

If you go

What: Women’s Health Series – Hormone Therapy & Alternatives

When: 6 to 7 p.m. Tuesday, Nov. 15

Where: Yampa Valley Medical Center conference rooms

Hot flashes, difficulty sleeping, anxiety.

Menopause comes with a range of symptoms, but the symptoms can be minimized with hormone therapy.

“If your symptoms bother you, there is treatment,” said Dr. Mary L. Bowman, OB-GYN at YampaCare For Women.

When taking hormones, Bowman recommends women follow a few principles.

“Be sure your treatment is individualized. Be sure you’re speaking with your doctor. Be sure what you’re taking has data behind it,” Bowman said. “And know that hormones can be a safe, helpful treatment.”

If you go

What: Women’s Health Series – Hormone Therapy & Alternatives

When: 6 to 7 p.m. Tuesday, Nov. 15

Where: Yampa Valley Medical Center conference rooms

Hormone therapy concerns

When used properly, hormones are safe. But women often still have concerns, in part, because of a large study conducted 15 years ago.

The Women’s Health Initiative hormone therapy trials found negative side effects of using hormones, including increased risk of breast cancer. However, the women in the study were starting hormone therapy long after menopause, which Bowman said comes with risks.

“The women they were giving hormones to were well past the age of menopause and had been without hormones for an extended amount of time, and that was a risky thing to do,” Bowman said. “If we time hormone therapy closer to the final menstrual period so we don’t allow those physiological changes from lack of estrogen to happen, then taking hormones turns out to be quite safe.”

Menopause basics

Menopause is defined as having no period through 12 months. On average, it begins at age 52, but many women begin menopause earlier or later.

Throughout a woman’s life, the brain communicates with the ovaries, telling them when to release various hormones. But the older women get, the harder it is for the ovaries to hear that signal.

“Periods can get less regular, hormonal symptoms can get worse and tend to ebb and flow, because some months, your ovary can respond properly, and some months, it doesn’t,” Bowman said. “Symptoms are very variable, which is why treatment has to be individualized.”

Hormone therapy “do’s”

While hormone therapy can alleviate common symptoms of menopause, it’s not meant to prevent other health issues.

For hormone therapy to be helpful and safe, women should stay connected with their doctor and begin the therapy within two to 10 years of their last periods.

For women ages 50 to 59 who had their last period less than 10 years earlier and haven’t had a hysterectomy, studies show that estrogen plus progesterone is a safe treatment. For women who have had a hysterectomy, estrogen alone is very safe.

There are various preparations that can be used for hormone therapy. Usually, the estrogen prescribed is estradiol, and the progesterone is a natural molecule made from peanuts.

“We’re using the hormones that our body would normally make,” Bowman said.

The risk of breast cancer can increase after five to seven years of hormone therapy, but the vast majority of women use hormones for a shorter period of time.

Women whose only symptoms are vaginal dryness or painful intercourse may want to consider using an estrogen cream, which comes with very few risks.

The bottom line? Women who are experiencing menopausal symptoms shouldn’t hesitate to talk with their doctors about treatment options.

“I think, a lot of the time, women don’t know the full benefits or are afraid based on that previous study,” Bowman said. “For somebody who does have bothersome symptoms, using hormone therapy and revisiting it every year in light of the new data is a very reasonable thing to do.”

Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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