Menopausal Hormone Therapy (HT): Care Instructions

Overview

Hormone therapy (HT) is medicine to treat menopause symptoms. These include hot flashes, vaginal dryness, and sleep problems. HT replaces the hormones that drop at menopause. You may start to get relief from these symptoms within weeks of starting HT.

HT may contain one or both of the hormones estrogen and progestin. HT may come in the form of a pill, patch, gel, spray, or vaginal ring. A vaginal cream, a vaginal tablet, or a vaginal ring that has a much lower dose of estrogen may be used to relieve dryness and other tissue changes in and around the vagina.

Like all medicines, HT has some risks. But for many people, the benefits of taking HT outweigh the risks. Talk with your doctor about whether HT is right for you. And talk to your doctor about having regular checkups while you are taking HT.

Why might you take HT?

HT is effective at treating symptoms of menopause. These include hot flashes, sleep problems, mood symptoms, and vaginal dryness. HT can also help slow bone loss that happens after menopause. And it may reduce the risk of colon cancer and type 2 diabetes.

Treatment with low-dose vaginal HT may also help prevent urinary tract infections (UTIs) and other urinary symptoms.

What are the risks of taking HT?

Taking HT can increase the risk of certain health problems for some people. But many people can take HT safely with little risk. Talk with your doctor about the risks and benefits of HT for you. A person's risk can depend on:

Age and when HT is started in menopause.

Short-term use of HT in early menopause has less risk than when it is started later in menopause.

• Starting HT later in menopause. This may increase the risk of heart disease, breast cancer, blood clots, stroke, dementia, urinary incontinence, and gallbladder disease.
• Starting HT earlier in menopause. This has much less risk. But it may slightly increase the risk of breast cancer, blood clots, stroke, urinary incontinence, and gallbladder disease.

Health history.

HT is not recommended if you:

• Could be pregnant.
• Have a personal history of blood clots, heart attack, or stroke.
• Have vaginal bleeding from an unknown cause.
• Have active liver disease.

If you have a history of breast or endometrial cancer, you may be able to take some types of HT but not others. Ask your doctor.

The type of HT.

• Low-dose vaginal estrogen HT, such as a cream, has less risk than other forms of HT.
• Risk can depend on whether estrogen is given alone or with progestin. If you don't have a uterus, your doctor may recommend estrogen-only HT. But if you do have a uterus, estrogen and progestin therapy is a safer option.