How Do You Know When to Take Hormones?
Without Menopause Symptoms, No Treatment Is Needed
Last week, I had a 49 year old woman in my office. She had not had a period for one year and was not having any uncomfortable symptoms or other problems typically associated with menopause. She asked me for hormone testing and hormone replacement therapy.
It took awhile for me to explain why she did not need either one. There is no point in running any labs for her hormone levels. She is menopausal. Her hormone levels will all be low, as they should be. There is no reason to give her hormones if she is feeling fine. Hormones are primarily reserved for women with significant symptoms such as hot flashes and night sweats. And if you don’t have symptoms, you have no need for treatment. In other words, if it’s not broken, don’t try to fix it!
Different Patient, Different Story
This morning, I talked with a 55 year old woman who told me she was tired of dealing with the menopause symptoms she has been experiencing, namely severe night sweats and moodiness. The night sweats were waking her several times at night and she was having hot flashes during the day, as well, which is not good for a busy professional woman.
In order to avoid taking hormones, she had been trying diet, exercise, meditation, herbs and vitamins, all without success. She was miserable and was finally ready to try hormones to get relief.
I asked her what her greatest fear was regarding hormone therapy. She said cancer. This patient has no history of breast cancer in her family, let alone any other cancer. I understand women’s fear of breast cancer and the use of hormones, but as with so many things in life, we must weigh the risks and benefits.
I am confident that this woman will get quick relief of her life disrupting menopause symptoms with estrogen. I am comfortable prescribing them as long as her annual clinical breast exam and mammograms are normal. It is great that she tried alternatives, first, but when they faiit’s time to move on to the next level of treatment - hormone therapy.
While there is no need to suffer through menopause, there is also no need to treat for menopausal symptoms if they don’t exist. So, talk with your health care provider to determine what is right for you.