Imagine living a third of your life with insomnia, fatigue, difficulty thinking, migraines, mood swings, sexual dysfunction, muscle and joint pain, unexplained weight gain and sudden episodes of being overheated and sweating. You may feel like suddenly you just aren’t yourself. This is the reality for many women today who may live for many years in post-menopause. The change in hormones associated with menopause can cause these symptoms and many others. Additionally, women’s risks of certain diseases, including heart disease, diabetes, osteoporosis and dementia increase after menopause.
HRT can be a useful tool for preventing disease and managing symptoms in perimenopausal and menopausal women, but sometimes fear and misunderstanding about HRT can prevent them from getting the help they need. It’s been more than 20 years since the Women’s Health Initiative (WHI) study was discontinued, and HRT was widely criticized. However, science evolves with new studies refining data, and the latest guidelines support HRT.
In medicine, various associations conduct and collate research to create guidelines and recommendations that guide medical practice. For perimenopausal and menopausal women, the North American Menopause Society (NAMS) is one such organization, and its guidelines help establish the standard of care. According to NAMS, “hormone replacement therapy (HRT) is most effective when started within 10 years of menopause onset or before age 60 for women who don’t have other contraindications.”
This defines a crucial window of opportunity for treatment. Starting HRT after this window can increase risks. On the other hand, many women enter menopause earlier due to surgeries, chemotherapy, autoimmune diseases, and other factors. For women entering menopause early, HRT might be even more important unless specific contraindications exist.
Not all women need to use HRT. However, women should be informed that HRT is a safe and effective option and should have a full evaluation to determine if it’s right for them. It is recommended that all women entering perimenopause consult their healthcare team to evaluate risk factors, discuss symptoms, and understand their options, including HRT. Women experiencing vaginal symptoms, pain during sexual activity, or urinary tract infections should consider local HRT. Women in early or premature menopause should discuss HRT before their window of opportunity closes.
