HORMONE REPLACEMENT THERAPY: IS IT FOR YOU?

Hormone replacement therapy (HRT) is medication that replaces the female hormone oestrogen, which your body stops making during menopause. It’s most often used to treat common menopausal symptoms, such as hot flushes and vaginal discomfort.

However, not everyone needs HRT in order to cope with menopause. According to Dr Natalia Novikova, a gynaecologist at Mediclinic CapeTown, menopause treatment may simply consist of adopting a healthy lifestyle through the reduction of stress factors, the practice of mindfulness, avoiding smoking, limiting alcohol(particularly avoiding red wine), and exercising regularly. “These are very important and work well in preventing and diminishing menopausal symptoms,” she says.

“Aside from menopause treatment, it’s important tohave regular general checkups, including blood sugar, blood pressure, cholesterol, mammogram, bone density, and cervical (pap) smear,” Dr Novikovaadds. “This will enable your doctor to ensure the symptoms you are experiencing are related to menopause and not caused by any illnesses.”

Dietary changes suggested for reduction of menopausal symptoms include avoiding processed food, refined sugars, red meat, and increasing your intake of fibre, complex carbohydrates and vegetables. “Supplementation with essential fatty acids, vitamin E, selenium and Vitamin C for hot flushes, calcium, vitamin D and magnesium for bone health, and vitamin B for dry skin and hair can also help.”

Hot flushes are usually caused by fluctuation of oestrogen levels. Some women experience none at all, others may have a few, and some get intense hot flushes that can interfere with the quality of life and daily activities. “The best treatment for hot flushes is the supplementation of oestrogen in the form of HRT,” Dr Novikova says. If you still have your uterus, oestrogen and progesterone will be prescribed together. If you don’t have a uterus, you can take oestrogen alone.

HRT isn’t for everyone, however. Don’t take it if you’ve ever had breast cancer, uterine cancer, blood clots, liver disease, or a stroke. “There are other ways of treating hot flushes for women who cannot take hormonal treatment, but unfortunately, they’re not as effective as oestrogen supplementation,”

Dr Novikova explains. These include antidepressant medication or medication usually used to treat high blood pressure. Dietary changes may be helpful for some women. “Mood changes and sleep disturbances are also caused by changes in levels of hormones and the above-mentioned treatment for hot flushes will also work for mood swings.”

There are two main types of oestrogen therapy:

• Systemic hormone therapy comes in pill, skin patch, ring, gel, cream or spray form and typically contains a higher dose of oestrogen that is absorbed throughout the body.

• Low-dose vaginal preparations of oestrogen come in cream, tablet or ring form and minimise the amount of oestrogen absorbed by the body. These are usually used to treat the vaginal and urinary symptoms of menopause.

Osteoporosis or thinning of bones is related to low oestrogen levels, and the rate increases once you get to menopause. “Taking calcium and doing weight-bearing exercises can help prevent osteoporosis,” says Dr Navikova. “Vaginal dryness, pain during sexual intercourse and frequent urinary and vaginal infection due to thinning of vaginal skin are all caused by low oestrogen levels. Treatment includes the use of lubrication during intercourse and the vaginal use of oestrogen cream.” •

This article first appeared on www.mediclinicinfohub.co.za on August 4, 2020