Menopause is a natural transition in a woman's life when her periods stop permanently and she can no longer get pregnant naturally. The transition is caused by changes in hormone levels, mainly estrogen and progesterone. Some women go through menopause with few symptoms, while others can have severe symptoms that greatly impact their quality of life.
To help manage troublesome symptoms, some women are prescribed hormone therapy in the form of tablets that contain estrogen, progesterone, or both. These tablets can help with hot flashes, night sweats, vaginal dryness, sleep disturbances, and mood changes. However, as with any medication, there are potential side effects to be aware of.
Common Side Effects
The most common side effects associated with menopause hormone tablets include:
- Breast tenderness or swelling: Estrogen can cause changes in breast tissue leading to pain, swelling, and tenderness. This usually subsides over time.
- Headaches: Headaches are a common reaction early in treatment but typically resolve within a few months of starting therapy.
- Irregular vaginal bleeding: Spotting or light bleeding may occur due to changes in the uterus lining from fluctuating hormone levels. This often improves with continued use.
- Nausea: Some women experience mild stomach upset when first taking tablets, but this usually resolves quickly.
- Fluid retention and bloating: Bloating, swelling of the limbs, and weight gain can occur due to fluid shifts in the body influenced by hormones.
- Mood changes: Some women report mood swings, anxiety, irritability, or depression, especially when therapy is first started. Symptoms often improve within 3 months.
- Skin reactions: Skin irritation, redness, or rashes have been reported with estrogen patches and gels. Reactions are less common with oral tablets.
Serious Side Effects
While less common, there are some serious health risks associated with hormone therapy that should be carefully considered before starting treatment:
- Blood clots: Estrogen increases the risk of blood clots in the legs and lungs, especially in women with other risk factors like obesity, smoking, or family history.
- Stroke: Several large studies found a slight increased risk of stroke in postmenopausal women taking hormones by mouth or using skin patches. Those with migraine headaches may be at higher risk.
- Breast cancer: Long-term use (over 5 years) of estrogen plus progesterone is associated with a small increased risk of breast cancer. There are fewer cases of breast cancer in women who take estrogen alone.
- Gallstones: Estrogen can increase cholesterol saturation of bile and slightly raise the risk of symptomatic gallbladder disease requiring surgery.
- Uterine cancer: Unopposed estrogen (without progesterone) substantially increases the risk of cancer of the uterus lining if used long term. Adding progesterone protects the uterus.
Other Considerations
- The risks of hormone therapy likely outweigh benefits if started more than 10 years after menopause begins. The closer to menopause therapy is started, the lower the risks.
- Certain health conditions may increase the risks of hormone therapy. Women with a history of blood clots, heart disease, liver disease, and other conditions should carefully weigh the potential benefits and harms with their doctor.
- Lower doses of hormones may provide symptom relief with fewer side effects compared to standard doses. Alternatives like over-the-counter products, lifestyle changes, and non-hormonal prescriptions may also help manage symptoms.
- Periodic follow up with a healthcare provider is recommended to monitor for side effects, check for cancers, adjust dosages, and determine if ongoing treatment is appropriate. Bloodwork and mammograms may be ordered on a regular basis.
If you are considering hormone therapy for
perimenopausal or menopausal symptoms, discuss all treatment options thoroughly with your doctor. Understand the potential benefits, risks, side effects and alternatives before deciding if hormone tablets are the right choice for you. Weigh the impact of your symptoms on quality of life against the risks. Tablets can provide great relief for some women but may not be right for everyone.
At
Elite Hormone Therapy, our compassionate doctors and nurse practitioners specialize in
perimenopause and menopause care. We take time to listen and develop customized treatment plans to meet each woman's unique needs and health goals. In addition to hormone therapy, we offer nutritional counseling, fitness advice, stress management techniques and non-hormonal options to help you thrive during this transition. Contact us today to schedule a consultation and take control of your menopause!
