Once you reach the menopause, your ovaries no longer produce an egg each month and your periods stop completely. This change occurs because your oestrogen levels fall and oestrogen is the female hormone that regulates your periods. As a result of these falling hormone levels you often develop a range of menopausal symptoms, which some women find distressing. If you are among the women with significant symptoms around the time of the menopause, drug treatment is available in the form of hormone replacement therapy, often referred to simply as HRT.
HRT had very bad publicity since WHI study in 2002. As a result many unfortunate women were refused HRT and have suffered from the menopausal symptoms. Almost after 12 years the doctors have succeeded to establish the safety of HRT and women should feel safe in the hands of HRT specialists like Dr Purkayastha. Please make an appointment to see Dr Purkayastha in any of her clinics in London.
The first stage of the menopause is the peri-menopause, during which time your periods may become heavier or lighter, or more or less frequent. However, this isn't the only change that occurs, as during the menopause a range of symptoms that can affect your physical and mental well-being develop. For instance, hot flushes, night sweats, vaginal dryness and headaches are common, as well as low mood, anxiety, fatigue and difficulty sleeping. While these symptoms typically last for 2 to 5 years, symptoms can last for longer and some, such as vaginal dryness, may worsen with age. In terms of the severity of your symptoms, you may find that if the menopause comes on suddenly, your symptoms might be more intense.
Although it is possible to manage mild menopausal symptoms using self-help strategies, when your symptoms interfere with your everyday life, medication offers a useful treatment. Hormone replacement therapy is most effective at reducing hot flushes and night sweats, with significant improvement in these symptoms within 4 weeks of starting treatment. However, vaginal dryness is also greatly reduced when taking HRT and it can additionally enhance sleep, mood and quality of life in women with severe menopausal symptoms.
That's not all that HRT can help with though, as around the time of the menopause falling oestrogen levels reduce your bone mineral density and increase your risk of cardiovascular disease. Restoring your oestrogen levels is known to preserve the strength of your bones and when this hormone therapy is used in the longer term can reduce your risk of bone fractures. While the link between HRT and heart disease is more controversial, suitable timing, dose and duration of treatment can offer women a favourable outcome when it comes to reducing cardiovascular disease risk. For instance, while beginning HRT once you are over 60 increases your risk of heart disease, your chances of heart disease are cut by half if you start hormone replacement within 10 years of the menopause.
Some women are concerned to use hormones to relieve their menopausal symptoms, as they have heard that hormone replacement is associated with adverse health outcomes. Although taking hormone replacement therapy may increase your risk of a blood clot or a stroke, this is less likely if you are under 60, do not have other risk factors or use low dose HRT, hormone patches or an oestrogen-only treatment. Similarly, use of HRT is linked to 1 additional case of breast cancer per 1000 women, similar to the increase in size brought by other risk factors for breast cancer such as a high BMI or not adhering to safe drinking limits. However, there is less risk when you use hormone therapy in the short-term and use a treatment that doesn't contain progesterone. Women who take HRT for an early menopause can also be reassured by the fact that HRT use does not appear to increase your breast cancer risk before the age of 50. While that is the case, anyone taking HRT in the longer term should complete regular breast examinations and attend mammograms.
Even though research shows that taking hormone replacement therapy is associated with an increased risk of a blood clot or breast cancer, when prescribed appropriately and monitored regularly, this helps to manage these risks. This is why it is essential you seek advice from a specialist who is experienced in prescribing HRT and is up to date with the latest evidence and guidelines in the area. Dr Sheela Purkayasthawill therefore assess your individual circumstances and provide information to help you make an informed decision about your choice of treatment. While short-term use of HRT is safe for most women, if you would prefer to discuss alternative treatment options, such as phyto-oestrogens or vitamin and mineral supplements, Dr Purkayastha is happy to do so.
To talk with Dr Purkayastha about your suitability for hormone replacement therapy or to find out about other options to manage your menopausal symptoms, make an appointment now.