Last but not least, menopausal HT can cause less serious but still annoying side effects, including breast soreness, spotting or bleeding, bloating, and headaches.
Who should avoid using HT?
Some people really shouldn’t use menopausal HT. Per the American College of Obstetricians and Gynecologists, this includes anyone who has ever had:
- Breast or endometrial cancer
- A heart attack or stroke
- Blood clots
- Liver disease
Those contraindications are specific to systemic hormone therapy, Dr. Dunham says. Local estrogen therapy delivered to the vagina “really stays in the vagina when used as prescribed,” she tells SELF.
How do I know if I should take HT?
First, Dr. Christmas says, it can be helpful to know that hot flashes and night sweats have an expiration date. “For the vast majority of people, they persist for about 4.5 years after the last menstrual period,” she says—though research shows that Black women tend to deal with them longer (even up to 10 to 11 years).
For someone with only occasional hot flashes, Dr. Christmas says, the prospect of having them for a few years might seem manageable without any particular treatment. (Here are some cooling products that might help.)
If that is not you, or you have other symptoms, talk to your doctor about the options—which do include non-hormonal therapies. Dr. Christmas points to several: Certain antidepressants, cognitive behavioral therapy, the anti-seizure medication gabapentin, and the overactive-bladder drug oxybutynin have all been shown to reduce hot flashes and night sweats. There’s also a new oral medication called Veozah that treats vasomotor symptoms by targeting certain brain receptors that help regulate body temperature.
Ultimately, everyone’s experience of menopause is different, Dr. Christmas says, and there’s no one magic pill for addressing symptoms.
A final word
It’s not always easy to find a health care provider who listens to you and will discuss your concerns about menopause—let alone go in depth on hormone therapy. “It’s like they don’t think it’s their job to meet you where you are, and say, ‘Okay, this is troubling you, let’s look into this,’” Jennifer McCarthy, a 52-year-old New Yorker, tells SELF. She went through something of a medical odyssey for her debilitating hot flashes and other symptoms. “They were like, ‘Just drink less wine, and stop with the coffee, and work out more, and meditate,’” McCarthy says.
Eventually, she found a physician who specializes in menopause and took the time to ask her “tons of questions.” McCarthy ultimately opted for an estrogen/progestin skin patch. “I’ve never had another hot flash…. And it’s slowed down my bone loss,” she says.
Unfortunately, Dr. Streicher says, many doctors lack education and training in menopause. She notes that NAMS has a search feature that helps you find a local person who is either a member of NAMS and/or a “certified menopause practitioner”—which means that they have taken a menopause exam, so that at least tells you the provider is interested in the topic and has basic knowledge.
“It’s not a guarantee they’ll be an expert,” Dr. Streicher says. “But it’s a good place to start.”
Related: