Menopause and Hormone Replacement Therapy
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Menopause and Hormone Replacement Therapy
Expert Insight from Hormone Specialist Sharzad Green, Pharm.D
HOT FLASHES & NIGHT SWEATS
If you are experiencing hot flashes and night sweats (also called vasomotor symptoms), you know how bothersome they may be. In some women vasomotor symptoms begin in the months leading to menopause. About 35-50% of perimenopausal women experience these symptoms. The rate increases with menopause. 30-80% of postmenopausal women report hot flashes and night sweats (1).
MENOPAUSE
When a woman’s menstrual periods stop permanently she is in menopause. This could happen as a result of natural aging or following surgery, chemotherapy, or irradiation. In case of natural menopause, a woman is menopausal if she has not had menses for 12 consecutive months (after other pathologic or physiologic causes such as nursing a baby are ruled out). The median age of women undergoing menopause in the US is 52 years (2).
As a woman gets closer to natural menopause, production of hormones decline, which may result in a number of symptoms. A drop in estrogen and Progesterone levels often cause hot flashes and night sweats (also called vasomotor symptoms). Other symptoms (which I will discuss in future blogs) may include vaginal and vulvar dryness, mood swings, changes in hair, skin and nails, sexual dysfunction, mental fog and sleep disturbances. All of these symptoms may ultimately negatively affect the woman’s overall quality of life.
Sharzad Green, Pharm. D., is a hormone replacement specialist & pharmacist at Community Clinical Pharmacy, in Mesa, Arizona. She offers private Hormone Replacement Consultations to find a tailored solution that fits your needs. Sharzad has had the privilege of working with over 6,000 patients and providers in the Valley and around the world.
HOW LONG DOES THIS LAST?
I am often asked about the length of time a woman would have to suffer before the symptoms go away.
There is no hard and fast rule but most women have hot flashes for 6 months to 2 years. However, according to one study, 26% of women had hot flashes for 6-10 years and 10% had them for more than 10 years (1).
According to the Study of Women’s Health Across the Nation (SWAN), vasomotor symptoms are most common among African-American women (46%), followed by Hispanic (34%), Caucasian (31%), Chinese (21%), and Japanese (18%) women.
Genetics, lifestyle, smoking and stress may all contribute to the length and prevalence of hot flashes and night sweats as well as other menopausal symptoms (3).
Women are living longer after menopause. As the average life expectancy of women in the US is at 82.1 years of age for white females (4), more women are experiencing heart disease and osteoporosis than before, both of which may substantially increase in menopause. This causes more women and their health care providers to be concerned about ways to address such diseases and consider hormone therapy.
TREATING SYMPTOMS OF MENOPAUSE
For many decades, Estrogen—with or without Progestogen (progesterone and progestin)—have been prescribed to manage menopausal symptoms. These two hormones have been the center of controversy as there have been conflicting results about their safety from multiple studies. However, they have often been prescribed to help alleviate symptoms of menopause, as well as to prevent cardiovascular disease (CVD) and osteoporosis. When determining whether hormone therapy is a viable choice or not, a woman’s overall health, risk factors for developing heart disease and osteoporosis, her family’s medical history, the severity of symptoms and other additional factors need to be carefully examined.
If you are questioning whether to take hormones or not, talk to your doctor or get in touch with an expert. Know that there are many options. A knowledgeable doctor or pharmacist can guide you through peri-menopause, menopause and beyond. Hormonal and non-hormonal approaches, lifestyle changes and OTC supplements may help bring back the quality of life you deserve.
related topics you’d like to know more about. And, as always, stay healthy!
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References
(1) The prevalence of hot flash and associated variables among perimenopausal women.
Res Nurs Health. 1985; 8(3):261-8 (ISSN: 0160-6891)
(2) National Institutes of Health State-of-the-Science Conference statement: management of menopause-related symptoms.
Ann Intern Med. 2005; 142(12 Pt 1):1003-13 (ISSN: 1539-3704)
(3) Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40-55 years of age.
Am J Epidemiol. 2000; 152(5):463-73 (ISSN: 0002-9262)
(4) CDC National Vital Statistics Reports, Volume 66, Number 4, August 14, 2017
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