Perimenopause Treatment – A Look at HRT and Estrogen Therapy
How hormone replacement therapy works and how it can relieve your symptoms
Hormone Replacement Therapy (HRT) is a treatment option that works by supplementing the body’s production of the hormone estrogen. During perimenopause, our ovaries start to produce less and sometimes fluctuating levels of estrogen, the primary female hormone that is responsible for regulating our monthly period. This reduction is in turn responsible for the various perimenopausal symptoms that we experience such as hot flashes, vaginal dryness, a lack of interest in sex, irregular periods, depression and weight gain.
To help with these symptoms, your doctor may prescribe hormone therapy that includes estrogen or estrogen and progestin, another hormone, which is given to women who still have their uterus intact. Estrogen is usually prescribed in the form of low dose birth control pill. It also comes in skin patches, vaginal rings, gels and creams.
Like all medicines, HRT has benefits and risks associated with its use. Aside from relieving the symptoms of perimenopause, most notably helping to regulate our periods, HRT is also thought to help the body fight osteoporosis and to reduce a woman’s risk for certain cancers like colon cancer.
However, studies have also shown that using HRT over long periods of time may increase a woman’s chances of getting heart attacks and strokes, blood clots, gall bladder disease, and certain types of cancers like breast cancer.
As a result of the serious risks associated with HRT, the US FDA has advised that HRT should be taken at the lowest dose that is effective and for the shortest possible time. HRT is not for everybody. If you suffer from cardiovascular problems, have had a heart attack or stroke, experience excessive vaginal bleeding or if you suspect that you may be pregnant, you should not take hormone therapy for your symptoms.
HRT used to be the standard perimenopause treatment doctors prescribe. However, in light of these studies on the risks of using HRT, many women have decided to explore alternative ways of dealing with perimenopause.
Some have advocated the use of bio-identical hormones, which acts to relieve the symptoms of perimenopause the way HRT does, but using hormones derived from plants. Since they are derived from plants, they are more similar to the natural estrogen found in our bodies and tend to be absorbed better, too.
No long term studies are currently available on the risks of taking bio-identical hormones so whether or not they carry the same risk as their more conventional sister therapy, HRT, is still up for debate.
Others are keener on changing their diet and lifestyle and use food and exercise to cope with the changes brought about by lower estrogen production. Aside from improving a woman’s overall health, eating well and exercising can also vastly improve how our body reacts to the changes brought about by perimenopause. Certain herbs like black cohosh and primrose oil are also thought to help relieve hot flashes, depression, difficulty sleeping, headaches and mood swings.
Before you decide to use hormone replacement therapy or alternative treatment options to manage your perimenopausal symptoms, you need to carefully weigh the benefits against the risks. Keep in mind that perimenopause is different for every woman, and so a one-size-fits-all solution is likely to fail. Try different options, research and learn more about alternative treatments, and most importantly, listen to your body. Ultimately, you are the only one who can choose the best treatment plan for you.
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