The ABCs of HRT

Finding safe solutions for menopause symptoms

Finding safe solutions for menopause symptoms

Menopause signals the end of a woman’s reproductive years. Estrogen and progesterone levels drop, menstruation ceases and the chance of pregnancy disappears.

Many women find this time in their lives carefree and enjoyable. Some experience uncomfortable and even stressful symptoms, including hot flashes, night sweats, sleeplessness, anxiety and a marked dip in energy. Experiencing any of these should prompt a visit to a primary care physician or gynecologist. Often, minor lifestyle adjustments can alleviate the discomfort.

However, some women find symptoms so severe they seek relief through other means, such as hormone replacement therapy (HRT) spas and treatment centers. They offer the promise of relief, but may deliver medications and therapies outside of the parameters considered safe by the Food and Drug Administration (FDA).

Many of these centers offer more than ways to relieve symptoms associated with menopause. Frequently women experience upselling — being offered cosmetic products that promise better skin and weight loss. When choosing to visit one of these businesses, women must take care to ensure that treatment will be safe and delivered by a medical professional.

Leigh S. Walsh, M.D., OB/GYN, cautions those seeking relief to speak with their primary care provider or OB/GYN first and be proactive in making sure that treatments they are offered are federally regulated.

“With hormones, women have to be really careful because a lot of the preparations are not regulated by the FDA,” Dr. Walsh said. “You just don’t know what you’re getting. Women really need to talk to their doctors about safety and stick to therapies that are regulated.”

For some women, hormone replacement is a viable, even beneficial, option — but not for all. The Women’s Health Initiative, a long-term national health study of more than 160,000 women, found that only a specific group of women benefit from hormone therapy, barring any external factors that could put them at risk.

“There is a benefit for women between age 50 and 59 who don’t have certain other medical conditions. It is different than what we once thought,” Dr. Walsh said.

The biggest advantage of using hormone replacement in this select group was found to be the prevention of osteoporosis. Women in estrogen-only replacement trials also experienced minor reductions in risk for breast cancer and heart disease.

For women visiting HRT spas, their age and health factors may not be taken into consideration, which could be detrimental. For instance, some spas offer HRT in the form of a pellet that is placed under the skin for up to six months.

Dr. Walsh cautions, “I’ve had patients talk to me about the hormone pellet and tell me positive things, but again, those pellets are not formed in preparations that are regulated, so you really can’t tell how much hormone you’re getting. It’s a safety issue. There is not a pellet that is regulated by the FDA that I’m aware of.”

Also, according to Dr. Walsh, you can’t always trust the packaging of many unregulated HRT preparations.

“It has been found that the level of hormone printed on the packaging is not the level of hormone found in the patient’s bloodstream,” she said.

For women entering menopause and seeking relief, it is always best to start by talking with their primary care provider or OB/GYN. One symptom that is especially worrying is heavy bleeding after confirmed menopause. It should be evaluated, as it can be a symptom of a more serious issue.

Most of all, women experiencing uncomfortable menopause symptoms should not be discouraged. Solutions are available.

“These days the great thing is that there are so many options,” Dr. Walsh said. “There are gels, creams, sprays, hormone and non-hormone replacement therapy.


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