Similarly, tibolone increases the risk of stroke in women from their mids. Women who commence HRT around the typical time of menopause have lower risks of cardiovascular disease than women aged 60 or more. Venous thromboses are blood clots that form inside veins. Women under 50 years of age, and women aged 50 to 60, face an increased risk of venous thrombosis if they take oral HRT.
The increase in risk seems to be highest in the first year or two of therapy and in women who already have a high risk of blood clots.
This especially applies to women who have a genetic predisposition to developing thrombosis, who would normally not be advised to use HRT. Limited research to date suggests the increased risk of clots is mainly related to combined oestrogen and progestogen in oral tablet form, and also depends on the type of progestogen used. Some studies suggest a lower risk with non-oral therapy patches, implants or gels or tibolone.
The endometrium is the lining of the uterus. Use of oestrogen-only HRT increases the risk of endometrial cancer, but this risk is not seen with combined continuous oestrogen and progestogen treatment.
There is no risk if a woman has had her uterus removed hysterectomy. The increased risk of ovarian cancer is very small and estimated to be one extra case per 10, HRT users per year. A recent review linked HRT to two types of tumours: serous and endometrioid cancers. Cholecystitis is a disease in which gallstones in the gallbladder block ducts, causing infection and inflammation. On average, there is a slightly higher risk that a woman will develop cholecystitis when using oral HRT, but patch treatment is associated with a lower risk.
Treatment for cholecystitis includes surgery to remove the gallbladder. Weight gain at the menopause is related to age and lifestyle factors. An increase in body fat, especially around the abdomen, can occur during menopause because of hormonal changes, although exactly why this happens is not clear. Normal age-related decrease in muscle tissue, and a decrease in exercise levels, can also contribute to weight gain. Most studies do not show a link between weight gain and HRT use.
If a woman is prone to weight gain during her middle years, she will put on weight whether or not she uses HRT. Some women may experience symptoms at the start of treatment, including bloating, fluid retention and breast fullness, which may be misinterpreted as weight gain. These symptoms usually disappear once the therapy doses are changed to suit the individual. HRT is not a form of contraception. The treatment does not contain high enough levels of hormones to suppress ovulation, so pregnancy is still possible in women in the perimenopause the time of hormonal instability leading up to menopause.
The aim of HRT is to restore female hormone levels, which can bring relief to many women. Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC. NHS inform has more information on this condition. Read more. You said:. Based on the information you gave us, we made the following recommendation:. Types of HRT There are two main types of HRT: Combined HRT oestrogen and progestogen — for women who still have their womb Oestrogen-only HRT — for women who have had their womb removed in a hysterectomy There are several ways that oestrogen can be taken, including: tablets — which can be taken by mouth a patch that you stick on your skin an implant — under local anaesthetic oestrogen gel — which is applied to the skin and absorbed oestrogen spray—which is applied to the forearm When required to protect the womb lining from being stimulated by oestrogen, progestogen is available as: combined with oestrogen in tablets combined with oestrogen in patches separately as tablets or a progestogen releasing coil Choosing the right HRT for you It is important to find the correct HRT to help your symptoms.
When HRT is not suitable HRT may not be suitable, or a specialist opinion may be needed, if you: have a history of breast cancer , ovarian cancer or womb uterus cancer have a history of blood clots, tablet HRT is not recommended but taking HRT through the skin can be considered have a history of heart disease or stroke have untreated high blood pressure — your blood pressure will need to be controlled before you can start HRT have liver disease are pregnant or breastfeeding In these circumstances, a different type of medication may be prescribed to help manage your menopausal symptoms.
If side effects continue after this time, see your GP so your treatment plan can be reviewed. Hormones used in HRT can have associated side effects, including: fluid retention bloating breast tenderness or swelling headaches indigestion depression vaginal bleeding If side effects persist, your GP may recommend an alternative treatment plan. Weight gain Many women believe taking HRT will make them put on weight, but there is no evidence that this is the case.
Understanding the benefits and risks Recent findings show that although not completely risk-free, HRT remains the most effective solution for helping with symptoms of menopause and is also effective for the prevention of osteoporosis.
Further information about the benefits and risks of HRT When to stop taking HRT Most women are able to stop taking HRT after their menopausal symptoms finish, which is usually two to five years after they start but in some cases this can be longer. Non-urgent advice: Speak to your GP if:.
It can also reduce the risk of osteoporosis. Some types of HRT contain both progesterone and estrogen , while others contain only estrogen. Sometimes they contain testosterone. Hormone treatment can help address a range of issues.
The right combination and dosage of the hormones will depend on the reason for prescribing this form of treatment. Menopause is not an illness. It is a natural transition from the years in which a female can reproduce to the next phase of life. Many people go through menopause without requiring any treatment.
However, if the transition causes troubling or distracting symptoms, a variety of treatment approaches are available. Learn more about what to expect during menopause. Levels of progesterone and estrogen fluctuate throughout each month, in females, contributing to the menstrual cycle. Levels of estrogen and progesterone start to fall when most females are in their 40s, but menstruation will continue for some time. Periods may become less regular, and hot flashes and other menopause symptoms may start to appear during this time.
While menstruation continues, it is possible to become pregnant, although the chances reduce with time. Perimenopause, or the lead-up to menopause, usually lasts for around 7 years , but it can occur for up to 14 years, according to the National Institute on Aging. On average, this occurs at the age of 52 in the United States. After menopause, it is no longer possible to become pregnant without medical assistance. Everyone experiences menopause differently, but hot flashes, mood changes, and other symptoms are common.
A study published in suggests that in more than half of females, vasomotor symptoms , such as hot flashes:. Menopause begins earlier for some people, and HRT can be helpful if this happens. Anyone who is scheduled to undergo surgery or another treatment that will affect their reproductive system should ask about the likelihood of experiencing early menopause.
You take the medication to replace the estrogen that your body stops making during menopause. Hormone therapy is most often used to treat common menopausal symptoms, including hot flashes and vaginal discomfort. Hormone therapy has also been proved to prevent bone loss and reduce fracture in postmenopausal women. However, there are risks associated with using hormone therapy. These risks depend on the type of hormone therapy, the dose, how long the medication is taken and your individual health risks.
For best results, hormone therapy should be tailored to each person and reevaluated every so often to be sure the benefits still outweigh the risks.
Hormone replacement therapy primarily focuses on replacing the estrogen that your body no longer makes after menopause. There are two main types of estrogen therapy:. If you haven't had your uterus removed, your doctor will typically prescribe estrogen along with progesterone or progestin progesterone-like medication. This is because estrogen alone, when not balanced by progesterone, can stimulate growth of the lining of the uterus, increasing the risk of endometrial cancer.
If you have had your uterus removed hysterectomy , you may not need to take progestin. In the largest clinical trial to date, hormone replacement therapy that consisted of an estrogen-progestin pill Prempro increased the risk of certain serious conditions, including:.
All of these risks should be considered by you and your doctor when deciding whether hormone therapy might be an option for you. If you haven't had a hysterectomy and are using systemic estrogen therapy, you'll also need progestin. Your doctor can help you find the delivery method that offers the most benefits and convenience with the least risks and cost.
You may be able to manage menopausal hot flashes with healthy-lifestyle approaches such as keeping cool, limiting caffeinated beverages and alcohol, and practicing paced relaxed breathing or other relaxation techniques. There are also several nonhormone prescription medications that may help relieve hot flashes. For vaginal concerns such as dryness or painful intercourse, a vaginal moisturizer or lubricant may provide relief.
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