Basic information for topics, such as "What is it?" and "How many people are affected?" is available in the Condition Information section. In addition, Frequently Asked Questions (FAQs) that are specific to a certain topic are answered in this section.
- What is menopausal hormone therapy (MHT)?
- What are the benefits and risks of MHT?
- Can herbs or other alternative remedies help relieve symptoms of menopause?
- How can I stay healthy during and after menopause?
- Are there disorders or conditions associated with menopause?
Menopausal hormone therapy (MHT) used to be called hormone replacement therapy (HRT). MHT is an umbrella term for the several different combinations of hormones available in different forms and doses. Some women use MHT to relieve some of the symptoms of menopause, such as hot flashes, night sweats, vaginal dryness, and mood swings. Women who still have their uterus take the hormones estrogen and progesterone, while a woman whose uterus has been removed just needs estrogen.
MHT may be given in the form of a skin patch, vaginal tablet or cream, oral pill, implant, injection (shot), vaginal ring insert, gel, or spray.
If your health care provider determines that you are a candidate for MHT, he or she will prescribe the best form and dose to treat your particular symptoms.
MHT can relieve hot flashes, night sweats, vaginal dryness, and mood swings.1 It also can help prevent bone loss, improve cholesterol levels, and lower the chances of colorectal cancer. But, like all hormones, MHT has side effects. They can include breast tenderness, cramping, bloating, spotting, or a return of regular periods.1
In addition, several large research studies found that MHT increases the risk of heart disease, stroke, blood clots, and breast cancer in some women. The risk of dementia in women who start MHT after age 65 also may be elevated.1
Women should talk with their health care provider to decide if MHT is right for them. If MHT is causing side effects, the health care provider may change the type or dosage to decrease the side effects.
Some women use herbal supplements or other alternative remedies to relieve symptoms of menopause. Some supplements may relieve symptoms in some women, but more research is needed to prove which ones work and which do not. In some cases, herbal supplements and alternative therapies pose additional risks.
A woman eating a lot of soy or using herbal supplements in an effort to control symptoms should tell her health care provider, because these remedies can affect how prescription drugs work. In addition, it is important to keep in mind that herbal supplements are not as closely regulated by the government as prescription drugs.
Some of the commonly discussed nontraditional treatments are listed below.
Phytoestrogens (pronounced fahy-toh-ES-truh-juhns) are estrogen-like substances found in some vegetables, legumes (such as soy), herbs, and grains that may relieve some symptoms of menopause. However, this hasn't been proven yet.2
Black cohosh has not been proven to reduce hot flashes, but some women say it's helped them. Black cohosh has had a good safety record.3
Red clover, which some women claim reduces hot flashes, was not proven in five controlled studies to be effective. However, few side effects and no serious health problems have been reported.4
Ginseng may help with menopausal symptoms such as mood swings and sleep disturbances, but it has not been proven effective for hot flashes.
Evening primrose oil appears to have no effect on menopausal symptoms.5 Side effects include stomach upset and headache.
In general, everything that you would otherwise do to stay in good physical shape can help you stay healthy during and after menopause:6
- Be physically active most days of the week for at least 60 minutes.
- Eat a low-fat, low-cholesterol diet with a lot of vegetables, fruits, and whole grains
- Get regular checkups.
- Get a flu shot every fall.
- Avoid stress.
Menopause is associated with a higher risk of other health conditions, but the risks can be minimized by taking appropriate precautions under a health care provider's advice.
- Osteoporosis is the thinning of bone tissue and loss of bone density. In menopausal women, estrogen loss is the leading cause of osteoporosis.7 It can be prevented through regular weight-bearing exercise, the consumption of calcium and vitamin D, the use of bone-strengthening drugs and, possibly, menopause replacement therapy. Good sources of calcium include low-fat dairy products; dark green leafy vegetables, including broccoli, bok choy, collards, and turnip greens; sardines and salmon with bones; soy beans, tofu, and other soy products; and calcium-fortified foods such as orange juice, cereals, and breads. If you have trouble getting enough calcium in your diet, you may need to take a calcium supplement such as calcium carbonate, calcium phosphate, or calcium citrate. If you are between the ages of 19 and 50, your daily calcium intake should be 1,000 mg. Between the ages of 51 and 70, your daily calcium intake should be 1,200 mg. Calcium from food sources provides better protection than supplements against kidney stones.
- Heart disease can be aggravated or precipitated by the loss of estrogen or by the use of menopausal hormone therapy in women at risk for heart disease.8 Women who have high blood pressure, cholesterol abnormalities, or a family history of heart disease, or who are overweight, are at a higher risk for heart disease.
- Pelvic floor disorders occur when supportive tissue in the pelvic cavity weakens and organs supported by that tissue fall out of place.9,10 As a result, the uterus, bladder, or walls of the vagina can fall into the vaginal opening. Prolapse and other disorders of the pelvic floor can be caused by the lack of estrogen in menopause.
- NIH National Heart, Lung, and Blood Institute. (2005). Facts about menopausal hormone therapy (NIH Publication No. 05-5200). Retrieved June 14, 2012, from http://www.nhlbi.nih.gov/health/women/pht_facts.pdf (PDF - 535 KB)
- National Center for Complementary and Alternative Medicine. (2010). Soy. Retrieved June 15, 2012, from http://nccam.nih.gov/health/soy/ataglance.htm
- National Center for Complementary and Alternative Medicine. (2010). Black cohosh. Retrieved June 15, 2012, from http://nccam.nih.gov/health/blackcohosh/ataglance.htm
- National Center for Complementary and Alternative Medicine. (2010). Red clover. Retrieved June 15, 2012, from http://nccam.nih.gov/health/redclover/ataglance.htm
- National Center for Complementary and Alternative Medicine. (2010). Evening primrose oil. Retrieved June 15, 2012, from http://nccam.nih.gov/health/eveningprimrose
- Women's Health.gov. (2010). Menopause. Retrieved June 15, 2012, from http://www.womenshealth.gov/menopause/menopause-basics
- MedlinePlus. (2010). Osteoporosis. Retrieved June 15, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/000360.htm
- Rosano, G. M., Vitale, C., Marazzi, G., & Volterrani, M. (2007, February). Menopause and cardiovascular disease: The evidence. Climacteric, 10, 19–24. [Abstract]. Retrieved June 15, 2012, from http://www.ncbi.nlm.nih.gov/pubmed/17364594
- Sze, E. H., & Hobbs, G. (2012). A prospective cohort study of pelvic support changes among nulliparous, multiparous, and pre- and post-menopausal women. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 160, 232–235.
- Medline Plus. (2011). Uterine prolapse. Retrieved June 15, 2012, from http://www.nlm.nih.gov/medlineplus/ency/article/001508.htm