Hormone Therapy

Hormone Therapy - What is it?

Hormone therapy is the prescription use of biochemically similar, naturally occurring hormones to help restore more normal functioning during periods of hormone fluctuations. 

Hormone fluctuations : age 40 and above

Women go through many expected phases of hormone fluctuations; puberty, pregnancy, and the natural process in our body during one’s 40’s and 50’s (called perimenopause and menopause) when these hormones decrease.  There are many hormones in this complex system, and they are mostly acting as signals to the rest of the body.  

• Perimenopause: estrogen, testosterone and progesterone fluctuations, may start in a woman’s 40s or 50s

• Menopause: ceasing of menstruation, one year after the last menstrual cycle

When those hormone signals get quieter, (as can happen with perimenopause), and menopause (when some hormones decrease significantly), sometimes our cells don’t know what to do.  For example, our brain cells in an area called the hypothalamus get confused with low levels of estrogen. With fluctuating or decreased estrogen, the hypothalamus can cause the body to make body temperature fluctuations, leading to hot flashes and night sweats. 

There are many symptoms associated with hormone loss, some of which we may not even realize are connected to hormones. When we utilize prescription hormone therapy, we replace the hormones the body may not be making anymore, and the replaced hormones help relieve symptoms. 

Why would I need hormone therapy?

Some women have life-disrupting symptoms which cause them to feel physically, emotionally, and mentally uncomfortable during their change of hormones.  They can experience hot flashes and night sweats, interrupted sleep, new-onset anxiety, decreased desire for intimacy, heart palpitations, fatigue, and joint and muscle pain.  Not every woman experiences the same symptoms!  For some, it’s not as intense, and they may be able to navigate changes in their body with more ease.  There is also strong evidence that hormone therapy can reduce the risks of dementia (in those with a family history).  It has beneficial effects for the heart and can reduce the rate of bone loss (osteoporosis) when started in early menopause.

• Likely reduction in symptoms such as hot flashes, weight gain, sleep problems, anxiety

• May possibly reduce risk of dementia

• Can benefit the heart

• Reduce the rate of bone loss if started early in menopause

Are there side effects associated with hormone therapy?

There can be side effects as the body adjusts to the dose, and finding the right dose is important.  That’s why in general it is good to start low and go slowly.  One might have side effects that feel like having a menstrual cycle including bleeding and bloating, breast tenderness, and mood changes.  On the other hand, a person taking hormone therapy might have few or no side effects, but great relief. Working with an experienced and knowledgable medical provider will help you navigate your concerns with your health journey.

How do I know hormone therapy is for me?

This is a highly personal decision, and a decision which needs a medical consultant. There are benefits and risks to starting any medical journey.

If you have a previous medical history that would put your health at risk if you used hormone therapy, and/or if it has been more than 10 years since your last menstrual cycle and over 60 years old, and never have been on hormone therapy, the risks could outweigh the potential benefits. This is conversation to have with a medical provider, like Tammy, who can help you weigh the benefits and risks.

Do I ever have to stop hormone therapy?

There are many reasons to continue hormone therapy.  This should be an ongoing conversation with your medical provider.  No one should ever cut you off without a reasonable, research-based, shared decision-making process.