Perimenopause symptoms are common and can be distressing, however you don’t have to live with them. Learn more about how hormone replacement therapy (HRT) can improve your quality of life.
Deciding if hormone replace therapy (HRT) is right for now? Dr. Oona O’Neill, a physician at Atrium Health Wake Forest Baptist Obstetrics and Gynecology Clemmons, explains how HRT can benefit many women.
The Most Common Perimenopause Symptoms
A woman is in menopause when she hasn’t had a menstrual period for one full year. Perimenopause is the transitional time approximately 5 years prior to menopause. During perimenopause, hormone levels can become erratic, which cause symptoms including:
- Hot flashes
- Night sweats
- Insomnia
- Changes in cognition or forgetfulness
- Anxiety
- Joint pain
- Vaginal dryness
- Low libido
- Fatigue
- Change in fat distribution to the abdomen
These symptoms can last the entire time a woman is in perimenopause and well after she’s gone into menopause.
Hormone Replacement Therapy: What to Expect
Hormone replacement therapy (HRT) can help address these often debilitating symptoms using either estrogen or estrogen and progesterone to stabilize hormone levels. O’Neill says HRT can also be beneficial for protecting heart and bone health.
O’Neill says it’s important to first rule out other possible causes of symptoms, such as normal metabolic aging, a thyroid disorder or arthritis. If a patient is a candidate for HRT, O’Neill will start her on a 12-week trial period to see how she feels and if she has side effects from the treatment.
HRT comes in several forms:
- Pill
- Patch
- Gel
- Spray
- Cream
- Vaginal ring
- Intrauterine device (IUD)
“If a woman still has her uterus, she’ll need to use some form of progesterone in addition to estrogen,” O’Neill says.
Is Hormone Replacement Therapy Safe?
Like any medication, HRT can come with side effects and risk factors. Possible HRT side effects include:
- Headache
- Breast tenderness
- Irregular bleeding
- Mood changes
“If side effects happen, we track them and make adjustments,” O’Neill says. “Women tend to feel so much better with HRT. Nine times out of 10, we get the right balance pretty quickly.”
HRT slightly increases the risk of blood clots, but this risk is lower than with combined oral contraceptive pills and lower than risk of clot during pregnancy, demonstrating the fact that clots are very rare. It’s important to discuss the risks versus the benefits with your provider, including sharing your personal and family health history to make an informed decision.
O’Neill says the benefits generally outweigh the risks in women who are within 10 years of menopause, which is typically between ages 50-60.
There are also many misconceptions about the safety of HRT.
“A lot of the information online is black and white - HRT is either ‘terrible’ or the ‘best thing ever,’” O’Neill says. “I think it’s amazing and can help so many women, but I wouldn’t give it to every single person, and I would select a formulation that is best for each individual woman based on her medical history and hormonal needs. It’s important to have a conversation with a knowledgeable health care provider who can help you determine what’s right for you.”
Find an Atrium Health Wake Forest Baptist OB-GYN near you.