Hi!
I am in my mid 40s and I’m starting to suspect that I’m having perimenoause symptoms (night sweats, unexplained joint pain, forgetting things etc). I see HRT is often a first line of defense. I seemed to have negative mood changes when on birth control, would HRT give a similar reaction?
And what is the goal with HRT? Does one use HRT to help transition the body through these changes in a more controlled slow way? Or is the idea to keep on them indefinitely?
Hi Karla, thanks for posting. HRT is quite different to birth control in many ways. It contains one of our human estrogens: 17 beta estradiol, instead of the synthetic estrogen which is in birth control pills. It contains this hormone at much more physiological (body friendly) doses than birth control as well, as the aim is to manage peri menopause symptoms, not to prevent pregnancy. This means that women usually tolerate it a lot better than birth control. The progesterone part of HRT is usually better tolerated too, as it is our human progesterone in a capsule (“micronized progesterone”). Of course, each woman is quite individual in her responses to hormones, so there are still some hormone related side effects which women might experience (e.g. nausea, headaches and breast tenderness, or unscheduled vaginal bleeding), but these often settle over the first 12 weeks of use.
In terms of the goal with HRT, the idea behind using it is to treat troublesome symptoms of peri menopause or menopause which are having a negative impact on quality of life. If a woman has one (or several) of these symptoms which are causing problems in day to day life, HRT is usually the first choice for improving these, as it is effective at doing so, and is also a safe option for many women. Using HRT does not slow down the transition into menopause and beyond. Your body will still go through this at the same age (and pace) as it would have done without HRT. Those things are determined mostly by genetics. HRT just allows this transition to feel more bearable for women. Many women will have symptoms of peri-menopause/menopause for around 7-10 years, so it is not at all unusual to use HRT for this length of time. There is no “cut off” age at which HRT must be stopped, when we are using the safest type (estrogen via the skin in patch or gel, and our human/micronized progesterone). The guidelines used to have a recommendation in there that women stay on HRT for 5 years and then come off it, but this was based on old data which has since been discredited. This recommendation has now been removed from the guidelines. So women can stay on this type of HRT for as many years as they wish, with annual reviews of effectiveness with their family doctor