Laura Donnelly, MD, and Erin DuMontier, MD, are back with another installment of 'Ask the OB-GYNs.' This week they discuss menopause and Hormone Replacement Therapy as a means to alleviate some menopausal symptoms.
When does menopause occur?
"Menopause occurs when there is a lack of menses for 12 consecutive months," Dr. Donnelly says. "The average age of menopause in the US is 51. Typically, no lab work is necessary to diagnosis menopause. However you should see your provider if you are younger than 45, your symptoms are interfering with your life, or you are experiencing heavy bleeding."
How do I know if I'm going through menopause?
“Menopause is preceded by perimenopause - a time when estrogen is declining," Dr. Donnelly explains. "This time span may last several years, and women may notice that menses become irregular. You may also develop hot flashes, vaginal dryness, night sweats, mood swings and/or sleep disturbances."
What is hormone replacement therapy (HRT)?
“Hormone replacement therapy is providing the female hormones, estrogen, progesterone, or both, to menopausal women to help alleviate the symptoms of menopause," Dr. Donnelly says. "It can be administered throughout the body in the form of pills, patches, gels, creams or sprays, or locally via the vagina in the form of rings, creams or pills. It can help alleviate the symptoms of menopause including hot flashes, sleep disturbance, mood swings, vaginal dryness. HRT should be used in the lowest effective dose for the shortest amount of time."
What are the benefits of hormone replacement therapy (HRT) used to treat symptoms of menopause?
“There are many benefits of HRT or estrogen therapy," Dr. DuMontier says. "Estrogen is used to treat hot flashes, which is the main symptoms of menopause. It also relieves vaginal dryness and can help relieve some changes that cause problems of the urinary tract after menopause. Estrogen protects against bone loss by slowing down the rate of bone loss after menopause, helping to prevent osteoporosis. Estrogen has also been shown to help reduce the risk of colon cancer."
What are the risks of hormone replacement therapy (HRT) used to treat symptoms of menopause?
"There are many known risks to HRT use in menopausal women," Dr. DuMontier explains. "In women with a uterus, using estrogen alone, the risk of endometrial cancer increases because estrogen causes the lining of the uterus to grow. Taking a progestin along with estrogen will decrease this risk of uterine cancer. The drawback of using a progestin is that it seems to increase the risk of breast cancer in menopausal women. Also, menopausal women may start bleeding again with the use of both estrogen and progestin, although this bleeding may occur for only a short time."
Laura Donnelly, MD, and Erin DuMontier, MD, are a part of BJC Medical Group and on staff at Missouri Baptist Medical Center. They practice at the Sunset Hills location of OB-GYN Associates of St. Louis, located at 3844 S. Lindbergh Blvd., Suite 235, Sunset Hills, MO. To make an appointment or find out more about them, please call (314) 725 -9300 or book online for Dr. Donnelly here >> or Dr. DuMontier here >>
To read other FAQs from the OB-GYNs, like breast health and the HPV vaccine, click here.