USF-COM Department of Family Medicine

Patient Education Information on... Index of Patient Education Topics

What is menopause?

Menopause is the transition between a woman’s childbearing years and her non-childbearing years.  This change can take months to years and is considered complete when a woman stops menstruating (having her periods).  It is a natural biological process that takes place in all women when their reproductive organs’, the ovaries, egg supply runs out causing them to produce less and less of the female hormones estrogen and progesterone.  The lowered level of  estrogen is responsible for the many symptoms of menopause.  Menopause most commonly occurs between the ages of 45 and 55.  It marks the beginning of a new phase of a woman’s life, a phase in which most women will spend 1/3 or more of her lifetime.  Most experts now view menopause as an estrogen deficient state that should be treated.

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What are the symptoms? (How do I  know when I am experiencing menopause?)

While each woman can experience unique menopausal symptoms, these are the most common. Return to top of page

What is Hormone Replacement Therapy?

Hormone Replacement Therapy, HRT, is simply giving women the hormones that their reproductive organs, the ovaries, have stopped producing, mainly estrogen.  It consists of an estrogen or estrogen / progesterone pill taken once a day for at least 3 weeks out of every month.  The decision of which pill to use is based on each woman’s individual characteristics.  In women who have not had their reproductive organs surgically removed, a process called a hysterectomy, progesterone is also given because it protects the uterus from any bad side effects that the estrogen can have on it.  The purpose of HRT is to prevent the effects that decreased estrogen has on a woman’s body.  By replacing the estrogen many of the menopausal symptoms can be avoided.

 Estrogen is the most effective method for controlling hot flashes and is approved by the FDA for that reason.  It can improve vaginal moisture and elasticity preventing itching and painful sexual intercourse.  It can also help prevent the uncontrolled urine flow and increased risk of urinary tract infections caused by menopause. Finally, HRT can help prevent the mood swings, irritability, and anxiety associated with menopause, and can help many women feel happy and more energetic.

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Are there other health benefits from HRT?

 It has been scientifically proven that HRT decreases the amount of bone lost during a woman’s postmenopausal years, especially when given in addition to 1500 mg of calcium a day, Vitamin D, and weight bearing exercises.  This can help slow or stop the development of osteoporosis, a condition in which the bones become weak.  Osteoporosis can lead to hip, wrist and spinal fractures, stooped posture, loss of height, and pain.

 HRT has also been shown to decrease the postmenopausal risk of heart disease by lowering the levels of  "bad" cholesterol (LDL) and raising the levels of "good" cholesterol (HDL) in the body. It also helps prevent blood clots which can lead to strokes and heart attacks.  Of course, eating right with a low fat / low cholesterol diet, not smoking, and exercising can reduce the risk of heart disease as well.  Heart disease is the #1 killer of postmenopausal women in the United States

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What are the risks of HRT?

Good question.  Most women who are thinking about taking HRT are concerned about the increased risks of cancer.  It has been known for some time that estrogen can promote cancer in women who still have their uterus, that is, those who have not had a hysterectomy.  However, the addition of the other hormone produced by the ovaries,  progesterone, to the HRT prevents this increased risk.  As for breast cancer, many studies have been carried out to investigate estrogen’s effect, but the results have been mixed.  Some studies show an increased risk while others show no change.  This risk is something that should be discussed with the woman’s physician and is an individualized part of the decision to take HRT.  Other important factors are the woman’s personal and family history of breast cancer.

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Is HRT right for me?

Weighing benefits and risks is a part of all medical decisions.  This is a particular decision that should be made with your physician.  Some physicians believe that HRT’s proven beneficial effects on heart disease, osteoporosis, and quality of life far outweigh any increased risks of cancer.  Other physicians feel that menopause can be handled most effectively by adjusting diet and exercise.  In the end, whether or not to use HRT is a decision that should be based on each individual’s personal characteristics, including the severity of their menopausal symptoms, their individual risk profile, and their health.  It should also involve the woman’s family history of not only cancer, but also heart disease, osteoporosis, and stroke.  And while some women have great improvements in the quality of their life from HRT, many others are happy and healthy without it.  Use this information with your personal physician to make the decision that is best for you.

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Websites for more information on Menopause & HRT