Hormone Therapy: Pros and Cons for Perimenopausal Women

Pros and Cons for Perimenopausal Women

This article originally appeared in Health Matters, a health information newsletter published by Clinton Hospital for members of the Greater Clinton community.

For many women, the months or years leading up to menopause can be a roller coaster ride laden with hot flashes, night sweats and vaginal dryness. During the usual five-year window of transition to menopause, known as perimenopause, a woman's hormone levels can become  irregular and unpredictable, leaving her to feel frustrated and uncomfortable as her body struggles to adjust. And while some women go through perimenopause with little disruption to their daily lives, others bear the burden of uncomfortable symptoms that can unexpectedly interrupt their days and nights, leaving them desperate for relief.

For many women looking for relief, hormone therapy may be considered to suppress the sometimes aggravating symptoms of menopause. "The decision to start hormone therapy should be arrived at jointly by the patient and her physician," said Valerie Moreland, MD, family physician. "Not every woman is a candidate for this form of medical intervention. Therefore, before beginning hormone therapy, the patient and her physician should discuss individual risks and benefits, the patient's current health and medical history, as well as her family's medical history."

Hormone therapy is a temporary treatment that replenishes a woman's estrogen and sometimes progesterone levels to help her body regain a normal hormone balance, thus alleviating perimenopausal symptoms. "For the treatment to be most effective with the least amount of risk, a patient should be given the lowest dose of hormones for the shortest time possible, and her condition should be reassessed every six months," said Dr. Moreland. "A woman should only receive hormone therapy if she is experiencing unbearable perimenopausal symptoms, has no prior health problems that the treatment could make worse, or is at a great risk for developing osteoporosis."

While protection against osteoporosis is an additional benefit of the treatment, risks associated with hormone therapy may include stroke, blood clot, heart attack or breast cancer. According to Dr. Moreland, under no circumstances should a woman take hormone therapy if she is experiencing vaginal bleeding that is not normal or if her medical history includes breast cancer, liver disease, heart disease, uterine cancer, a history of blood clots or some forms of elevated cholesterol, among other considerations.

Other prescription medications to help curb hot flashes are available to women who do not want or are not candidates for traditional hormone therapy, as well as alternative or
complementary medicine treatments using natural products. Dr. Moreland encourages women to talk to their health care provider individually about the best form of treatment for them.

Valerie Moreland, MD, is on the medical staff at Clinton Hospital and is a UMass Memorial Medical Group physician at Sterling Family Medicine, 50 Leominster Road, Sterling. She is currently accepting new patients. To make an appointment, call 978-422-5082.