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Understanding the Pros and Cons of Hormone Replacement Therapy for Menopause

Menopause is often referred to as “the change.” You might also hear terms like “reverse puberty” and “ovarian retirement.” For most women and individuals assigned female at birth, menopause happens in the mid-forties to early fifties. However, for some, the change can happen at an earlier age.

If you have your ovaries removed, you instantly enter menopause. Others transition earlier due to genetics, certain health conditions, and treatments like chemotherapy. Regardless of how and when you enter menopause, the symptoms can wreak havoc on your daily life. Think mood swings, brain fog, hot flashes, night sweats, and vaginal dryness. On top of all that, the decline in estrogen also increases your risk of breaking a bone and having a heart attack.

Tolerating the symptoms and side effects might be the right path if they’re mild. But many think about hormone replacement therapy at some point. Knowing the pros and cons before you start helps you and a doctor make the best decision. Here are the main points to keep in mind:

Helps Manage Health Risks

A drop in estrogen may not seem like a big deal. You’ve made it through puberty when your hormones started ramping up, so your body can surely survive a decline. While a reduction in estrogen and progesterone isn’t the end of the world, it can increase the chances of developing certain health conditions.

These health conditions include recurrent urinary tract infections or UTIs, osteoporosis, and Alzheimer’s. Estrogen keeps the good bacteria in your bladder and vagina at adequate levels. The hormone is also thought to help protect against bone loss and cognitive decline.

Hormone replacement therapy in combination with a UTI supplement can prevent future urinary tract infections. When estrogen levels are restored, your body’s organs and systems benefit from the role the hormone plays. Your urethra muscles don’t weaken as fast. Neither does your bone density. Plus, your brain doesn’t turn to its white matter for energy and continues to use glucose instead.

Improves Mood

The hormonal shifts that happen during menopause increase a person’s risk for depression and anxiety. Yep, female hormones can impact serotonin levels in the brain. When your ovaries begin to produce fewer hormones, serotonin also drops off. Less serotonin can increase irritability, sadness, and anxiety.

Hormone replacement therapy gives much-needed support for mood swings and other mood-related symptoms. No one wants to go through life feeling as if they’ve lost pleasure in activities they used to enjoy. Likewise, you don’t want to feel unable to handle stressors and situations you would normally navigate with ease.

Getting your estrogen and progesterone levels back on track restores your sense of normalcy. It can make a difference when you wonder why you’re suddenly not feeling like yourself. Experiencing depression and anxiety during menopause isn’t a weakness. There are biological reasons behind it, and hormone replacement therapy can provide relief.

May Increase Cancer Risk

Hormone replacement therapy can slightly increase the risk of breast and uterine cancer. But it depends on your family and personal history and what type of hormones you take. A personal history of hormone-receptor-positive breast cancer can make you a less-than-ideal candidate. If you still have your uterus, estrogen-only therapy won’t be your best bet.

An analysis of studies with women who had a history of breast cancer uncovered a shocking statistic. The risk of their breast cancer returning increased by 46% with hormone replacement therapy. A strong family history of breast cancer may also make hormone replacement therapy a no-go. It depends on the type of cancer that runs in your family and whether progestin-only treatment is more appropriate.

Progestin is the synthetic version of progesterone, which influences the lining of your uterus and stops ovulation during pregnancy. Taking only estrogen replacement therapy while you have your uterus may increase your risk of uterine cancer. Knowing your health risks and discussing them beforehand helps a medical practitioner point you toward the most suitable options.

Can Increase the Chances of Blood Clots and Stroke

Taking synthetic hormones can also slightly increase your chances of developing blood clots and having a stroke as well. The exact risk level depends on age, health condition, and type of hormone therapy. Lifestyle factors can also play a role. Being a smoker, for instance, enhances your risk.

Starting hormone replacement therapy 10 years after menopause tends to heighten your risks. Choosing not to wait this long gives you better odds. Having a personal or family history of blood clots and strokes naturally increases your chances.

You may decide not to pursue hormone replacement therapy because of your medical history. Alternative medications, such as antidepressants, might be a better choice to help you manage your symptoms. Some alternatives are available over-the-counter, including lubricants. If you have concerns about hormone replacement therapy’s risks, be sure to ask whether other solutions are OK for you.

Hormone Replacement Therapy During Menopause

The decision to take hormone replacement therapy isn’t as simple as wanting to get rid of your menopausal symptoms. Your current health, personal risk factors, and individual characteristics will come into play. Hormone replacement therapy offers many benefits, including the reduction or elimination of unbearable symptoms like severe hot flashes.

But hormone replacement therapy isn’t for everyone, even if you don’t have a risk factor like previous breast cancer. You may decide some of the side effects of synthetic hormones, such as headaches and acne, aren’t for you. Being open about the extent of your symptoms and needs helps a doctor present all the options before you choose.

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