Hormone Therapy, Testing & Replacement in Tyler and Lindale

Hormone Therapy Q & A

What is Hormone Therapy?

Hormone therapy is a medical treatment used to supplement or replace hormones that the body is no longer producing in sufficient amounts. It is often used to relieve symptoms associated with menopause but can also be prescribed for other reasons, such as preventing osteoporosis or treating certain hormonal imbalances.

Why Consider Hormone Therapy?

As women approach menopause, typically starting in their mid-40s (a phase called perimenopause), the ovaries gradually produce less estrogen. This hormonal shift can lead to various symptoms. Hormone therapy can help alleviate many of these common issues:

• Hot flashes and night sweats: Systemic estrogen therapy is considered the most effective treatment for these vasomotor symptoms.
• Vaginal dryness and discomfort: Both systemic and local estrogen therapies can relieve vaginal dryness, itching, burning, and pain during intercourse.
• Sleep problems: By managing night sweats and other symptoms, hormone therapy can contribute to improved sleep.
• Mood changes: Some individuals experience improved mood and overall well-being with hormone therapy.
• Bone loss prevention: Systemic estrogen helps protect against bone density loss (osteoporosis) that can occur after menopause.

Types of Hormone Therapy for Menopause

The main types of hormone therapy focus on replacing estrogen, and sometimes, progestin:

• Estrogen-Only Therapy (ET): Typically prescribed for women who have had a hysterectomy (uterus removal). Taking estrogen alone without a uterus can increase the risk of endometrial cancer, but this risk is not present if the uterus has been removed.
• Estrogen Plus Progestin Therapy (EPT): Also known as combined therapy, this includes both estrogen and progestin, a synthetic form of progesterone. Progestin is added to protect the uterus from the increased risk of cancer associated with estrogen-only therapy.

Forms of Administration

Hormone therapy can be delivered in various ways:

• Systemic Therapy: Distributes hormones throughout the bloodstream to reach various organs and tissues. Forms include:
  • Oral pills
  • Skin patches
  • Gels or sprays applied to the skin
• Local Therapy: Applied directly to a specific area, typically for vaginal symptoms. Forms include vaginal creams, rings, or tablets.

Benefits and Risks

Like any medical treatment, hormone therapy has both benefits and risks that should be discussed thoroughly with your healthcare provider.

Potential Benefits

• Effective relief from moderate to severe menopausal symptoms like hot flashes, night sweats, and vaginal dryness.
• Prevention of bone loss and reduction in fracture risk.
• Potential reduction in colon cancer risk with combined therapy.
• May help manage symptoms related to early menopause (before age 45).

Potential Risks

The risks associated with hormone therapy can depend on the dosage, type of therapy, duration of use, age at initiation, and individual health history. Potential risks may include:

• Blood clots, stroke, and heart attack: Risk may be higher, particularly when starting therapy later—age 60+, more than 10 years past menopause, or with certain pre-existing conditions. The delivery method (e.g., patches vs. pills) might influence this risk.
• Breast cancer: Long-term use of combined therapy is associated with a small increased risk. Estrogen-only therapy's impact on breast cancer risk is less clear and may depend on duration of use.
• Endometrial cancer: Increased risk if estrogen is taken without progestin in women with a uterus.
• Gallbladder disease: A small increased risk is associated with hormone therapy, especially oral forms.

Is Hormone Therapy Right for You?

The decision to use hormone therapy is highly personal and should be made in consultation with your doctor at Tyler Internal Medicine Associates P.A.

Factors to consider include:

• The severity of your symptoms and their impact on your quality of life.
• Your personal and family medical history (including history of cancer, heart disease, stroke, blood clots, liver disease).
• Your age and time since menopause onset.
• Your preference regarding treatment options.

Generally, the benefits are considered most likely to outweigh the risks for healthy individuals who start hormone therapy before age 60 or within 10 years of menopause onset to manage moderate-to-severe symptoms.

Treatment is typically recommended at the lowest effective dose for the shortest duration necessary.

Potential Side Effects

Some individuals may experience side effects, especially when first starting hormone therapy. These are often mild and may resolve over time. Common side effects can include:

• Vaginal spotting or bleeding
• Breast tenderness
• Bloating
• Headaches
• Mood changes

If side effects are bothersome, discuss adjusting the dose or form of therapy with your provider.

Alternatives to Hormone Therapy

For those who cannot or choose not to use hormone therapy, alternative options exist to manage menopause symptoms, such as:

• Lifestyle modifications, including weight management, exercise, and stress reduction.
• Over-the-counter vaginal moisturizers and lubricants.
• Non-hormonal prescription medications, including certain antidepressants, gabapentin, and ospemifene.
• Plant-based therapies or supplements.

Know Your Options

If you are experiencing symptoms of menopause or have questions about hormone therapy, schedule an appointment with Tyler Internal Medicine Associates P.A.

We are here to help patients in Tyler and Lindale understand their options and make informed decisions about their health.