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Hormone Therapy

What is hormone therapy?
How does estrogen affect the reproductive system?
How do estrogen levels change over time?
What are some of the symptoms of menopause that are…
What are hot flushes?
How does loss of estrogen affect the vagina and urinary…
How does hormone therapy help protect against osteoporosis?
What are some factors that should be considered when…
How is hormone therapy administered?
What are the risks associated with the use of hormone…
Are there other options available that can treat menopause…

What is hormone therapy?

  • Involves taking hormones to relieve symptoms of menopause

What are hormones?

  • They control how certain organs work
    • They are made by glands in the body
    • Androgen hormones are made by ovaries and testes
    • The ovaries use androgens to make estrogen
  • Ovaries make estrogen from puberty until menopause

How does estrogen affect the reproductive system?

  • In women, estrogen plays key role in reproductive system
  • Changes in estrogen levels lead to menstrual periods
  • Estrogen is made during the entire menstrual cycle
    • Causing the uterine lining to thicken each month
  • Estrogen also affects bones and cardiovascular health

How do estrogen levels change over time?

  • Estrogen production decreases as females age
  • At some point, ovaries stop making enough estrogen to thicken the uterus
    • Menstrual periods stop and menopause occurs
    • This may occur between the ages of 45 to 55 years of age
  • If the ovaries are remove during surgery
    • Estrogen levels drop suddenly
    • Bringing about symptoms of menopause
  • Women can take hormones
    • To relieve symptoms of menopause

What are some of the symptoms of menopause that are…

  • Decreased estrogen levels may cause:
    • Hot flushes
    • Vaginal dryness
    • Osteoporosis (bone loss)

What are hot flushes?

  • This is a sudden feeling of heat that spreads over the face and body
    • Skin may redden like blush
    • Sweating may occur
  • Hot flushes may last a few seconds to several minutes or longer
  • Hot flushes may occur several times a day or a few times a month
  • Flushes can happen day or night
    • When flushes occur at night, your sleep may be disrupted
  • Estrogen can help relieve hot flushes

How does loss of estrogen affect the vagina and urinary…

  • Loss of estrogen causes changes in the vagina
    • The lining tends to thin and dry
      • Causing pain during sex
    • The vagina may become more prone to infection
      • Which may cause burning and itching
  • The urinary tract also changes with age
    • It may become dry, inflamed or irritated
    • Some women may need to urinate more often
    • Increased change of bladder infection after menopause
  • Hormone therapy can relieve these symptoms

How does hormone therapy help protect against osteoporosis?

  • Osteoporosis in women may result from low estrogen levels
    • Estrogen helps to protect against bone loss
  • After menopause, female’s bones slowly lose strength
    • They become more fragile
    • And more likely to break
    • Hip, wrist and spine are most often affected
  • Hormone therapy can help slow bone loss after menopause
    • Estrogen helps to preserve bone
    • It works with other hormones to increase bone mass

What are some factors that should be considered when…

  • The decision to take hormone therapy depends on your personal needs:
    • Medical and family history
    • Symptoms
    • Risk of bone loss
    • Age at menopause

How is hormone therapy administered?

  • If you have a uterus
    • Therapy includes both estrogen and progestin (another hormone)
      • Estrogen alone causes uterine lining
      • Increases the risk of endometrial cancer
      • Progestin prevents uterine lining from growing to much
  • Hormone therapy can be given in many ways:
    • Orally
    • Vaginally (cream, pill, or ring)
    • Transdermally (through the skin)
  • When you take therapy depends on the type your administered:
    • Cyclic therapy:
      • Estrogen is taken for 25 days
      • Progestin is added on certain days
      • The exact time may vary
      • During times you are not taking progestin, bleeding may occur
    • Combined therapy:
      • Estrogen and low dose progestin are taken every day
      • Irregular bleeding is common the first few months
      • Within a year, bleeding should stop
    • Estrogen only therapy:
      • Estrogen is taken every day for 25 days per month or more

What are the risks associated with the use of hormone…

  • The Women’s Health Initiative found that hormone therapy may increase the risk of:
    • Heart attacks
    • Strokes
    • Blood clots
    • Breast cancer
  • Risks vary depending on how far a woman is past menopause
  • Recommendations:
    • Take the smallest dose of hormone therapy that works
    • Take therapy for the shortest possible time
    • Even so, monthly bleeding may resume
    • You may find this bothersome

Are there other options available that can treat menopause…

  • Other options include:
    • Antidepressants
    • Herbal products
    • Bioidentical hormones
  • The above products have limited information about effectiveness
  • Some products are helpful in the short-term treatment of symptoms
  • Some may cause harm
  • Herbal products and bioidentical hormones are not approved by the FDA

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