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Menopause occurs when your menstrual cycle stops because of low hormone levels and typically starts between the ages of 45 and 55 but can start earlier. It often comes with a variety of negative symptoms that can be very distressing. But that’s where hormone replacement therapy comes in. This life-changing treatment can give you the relief you deserve.

What is MHT?

Menopause hormone therapy (MHT) is a medication that typically contains female hormones (oestrogen and progesterone) and is taken to replace estrogen that your body stops making once you start menopause. It can be very helpful in alleviating symptoms of menopause, like hot flashes, night sweats, mood swings, insomnia, and vaginal dryness.

There are main types of MHT:

  • Systemic hormone therapy: This is estrogen that comes in a pill, patch, ring, cream, gel, or spray. The body absorbs the estrogen and addresses a number of menopausal symptoms. 
  • Low-dose vaginal products: Low-dose vaginal estrogen comes in a cream, tablet, or ring and provides a minimal amount of estrogen. It’s often used to treat the vaginal or urinary symptoms of menopause.

Who is a Good Candidate for MHT?

Many women going through menopause can be good candidates for MHT, but some criteria we look for at MAIA in Downers Grove include:

  • Having moderate to severe hot flashes
  • Experiencing vaginal dryness, itching, burning, or discomfort during sex
  • Night sweats
  • Looking to prevent bone loss or fractures and osteoporosis
  • Experiencing early menopause
  • Have an estrogen deficiency
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Dr. Wolowick and Dr. Mitchell are renowned for their exceptional expertise and dedication to patient care. Their comprehensive knowledge and innovative approaches have consistently led to outstanding treatment outcomes. Patients and colleagues alike deeply appreciate their commitment to advancing medical practice and improving patient well-being.

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HRT is not appropriate for everyone. It may not be for you if:

  • Have or had breast cancer, ovarian cancer, or uterine cancer.
  • Have abnormal vaginal bleeding.
  • Have had blood clots
  • Have a history of stroke, heart attack, or an increased risk for heart disease
  • Are pregnant
  • Have gallbladder or liver disease

MHT Treatment Options

There are a couple of different MHT treatment options, and which one is right for you depends on your symptoms and overall health.

Estrogen Therapy

Estrogen therapy involves taking only estrogen. Your provider will often prescribe a low dose of estrogen to begin with and up the dose as needed. This is most often recommended for those who have had a hysterectomy.  Estrogen comes in many forms, including:

  • Pills you take by mouth
  • Patch you apply to the skin
  • Gel placed inside the vagina
  • Ring you wear inside the vagina
  • Cream you apply to the vagina
  • Tablet you place inside the vagina
  • Spray you apply to your arm

Combination Therapy

Combination therapy combines estrogen and progesterone and often comes in a pill, patch, or IUD that’s placed in the vagina. This type of MHT is recommended most for those who have not had a hysterectomy, as the uterus needs progesterone.

What to Expect with MHT

When you start MHT with our providers at MAIA, Dr. Wolowick or Dr. Mitchell will start you on the lowest dose and then adjust it as needed until your symptoms are under control. People who stop producing estrogen before the age of 40 often take a higher dose to replace what their ovaries would typically produce at that age.

With estrogen-only therapy, you typically take it (or apply it) once a day.

Combination therapy can be taken in two different ways. With continuous-combined therapy, you take estrogen and progesterone once a day every day. With cycle therapy, you take estrogen every day and progesterone 12-15 days each month.

FAQs on MHT

Is it possible to switch between different types or forms of MHT?

Yes, your provider can adjust your dose or switch you to another form of MHT, such as patches, gels, creams, vaginal rings or pills. This flexibility helps ensure you find the most tolerable and effective option. We never recommend pellets as the doses are often way too high and not well regulated.

Can MHT help with symptoms beyond hot flashes and night sweats?

MHT can improve other menopause-related symptoms such as mood changes, sleep disruptions, some joint pains and vaginal dryness. The extent of symptom relief varies by individual.

How does MHT affect my risk of osteoporosis or bone fractures?

Estrogen helps maintain bone density and reduces the risk of osteoporosis and fractures in women who begin therapy around menopause. This benefit is one of the key reasons MHT is sometimes recommended.

What are the options for MHT if I have had a hysterectomy?

Women who have had a hysterectomy often only need estrogen therapy, since progesterone is not required to protect the uterine lining. Your provider will recommend the best type and delivery method based on your health history.

Are there non-hormonal alternatives if I am not a candidate for MHT?

Yes, non-hormonal medications, lifestyle modifications, and natural therapies may help manage symptoms. Medication options include Veozah, gabapentin, and antidepressants which can all help to reduce hot flashes and night sweats.

Should MHT be used if I enter menopause prematurely, before age 45?

MHT is recommended for women with premature menopause to support bone, heart, and overall health until the typical age of natural menopause. This helps protect against long-term health risks.

How long can I safely stay on MHT, and do I need to stop at a certain age?

The duration depends on your symptoms, health risks, and preferences. Many women can safely use MHT for several years under medical supervision, with annual check-ups and mammograms.

Is testosterone ever used for women, and what symptoms might it address?

Testosterone can sometimes be prescribed for post-menopausal women, typically to help with low libido. It must be monitored closely to avoid side effects.

What are bioidentical hormones?

Bioidentical hormones are hormones made in a lab that are chemically identical to thernhormones naturally produced by the human body. They are designed to act in the body thernsame way your own hormones do.

Are bioidentical hormones “natural”?

Not necessarily. Even though they may be derived from plant sources like soy or yams,rnbioidentical hormones are still processed and manufactured in a laboratory. “Bioidentical” refersrnto their chemical structure, not whether they are natural or organic.

Are bioidentical hormones safer than other hormone therapies?

No, not automatically. The term “bioidentical” can make them sound safer, but safety dependsrnon how the hormone is made, tested, dosed, and monitored — not just whether it matches yourrnbody’s hormones.

What is the difference between FDA-approved and compounded bioidentical hormones?

FDA-approved bioidentical hormones are tested for safety, effectiveness, and consistentrndosing. Compounded bioidentical hormones are custom-mixed by a pharmacy for an individualrnpatient and are not regulated or tested by the FDA in the same way. This can lead torninconsistencies in strength and quality.

Why can compounded hormones be riskier?

Compounded hormones are not required to go through the same strict quality control asrnFDA-approved medications. This increases the chance of incorrect dosing, contamination, orrnvariability from batch to batch.

Are all prescription hormone therapies bioidentical?

No. Some prescription hormones are bioidentical, while others are synthetic or derived fromrnanimal sources and are not chemically identical to human hormones. Both types may be used inrnmedical treatment depending on the patient’s needs.

Why don’t all drug companies make only bioidentical hormones?

Bioidentical hormones themselves cannot be patented because they are identical to hormonesrnalready found in the human body. However, drug companies can patent unique deliveryrnsystems, like patches, gels, or special formulations, which is often how FDA-approvedrnbioidentical options are developed.

What does “regulated body-identical hormone therapy” (rBHT) mean?

This term is used by some experts to describe bioidentical hormones that are alsornFDA-approved and regulated. It helps distinguish them from compounded hormone therapiesrnthat are not overseen by the FDA.

What do medical organizations recommend about bioidentical hormones?

Organizations like the American College of Obstetricians and Gynecologists recommend usingrnFDA-approved hormone therapies rather than compounded bioidentical hormones. This isrnbecause approved therapies have been tested for safety, quality, and effectiveness.

Who should I talk to before starting hormone therapy?

You should always talk with a qualified healthcare provider who can review your symptoms,rnmedical history, and risks. They can help you choose a hormone therapy that is safe,rnevidence-based, and properly monitored.

Schedule A Conversation

Don’t let menopause rule your life! With menopause hormone therapy, you can finally achieve the relief you’re looking for. Take the first step and schedule a consultation at MAIA today! Call our Downers Grove, IL office at 630-320-6703 or use our online contact form. We happily serve the Naperville, Downers Grove, Chicago, and Aurora, IL areas.

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