Everything You’ve Ever Wanted to Know (But Were Scared to Ask) About Menopausal Hormone Therapy – AOL

If youve beenor are goingthrough menopause, you know it can be a doozy, between the acne, sleep difficulties, cognitive symptoms and lets not forget the hot flashes. One treatment for these symptoms is menopausal hormone therapy (MHT)which you might know by the name hormone replacement therapy, a treatment that replaces the hormones that your body isnt making enough of, thereby improving menopause symptoms like vaginal dryness and changes in mood. I checked in with Dr. Mary Jacobson, MD, to learn more about MHT, including benefits, risks and alternatives.

Dr. Mary Jacobson, MD, is the Chief Medical Officer of Hello Alpha, which aims to empower women to take control of their personal healthcare by providing patients with access to simple, everyday medical needs. Dr. Jacobson is an accomplished academic, board-certified obstetrician and gynecologist and minimally invasive surgeon with extensive experience in clinical care, medical education, hospital operations and research.

First things first, Dr. Jacobson tells me that hormone replacement therapy is an outdated phrase based on the mistaken belief that femalemenopausesignified a hormone deficiency. Instead, she says, The phrase, menopausalhormone therapy (MHT) or hormone therapy (HT),albeit nuanced, recognizesmenopauseas a natural stage of reproductive life.

Hormone therapy comes in many forms, including:

Per Dr. Jacobson, menopausal hormone therapy treats:

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Dr. Jacobson tells me that MHT is FDA-approved for:

Moderate to severe VMS

Prevention of osteoporosis in postmenopausal women

Treatment of low estrogen levels due to hypogonadism (when your body does not produce enough sex hormones), removal of both ovaries, or primary ovarian insufficiency

Treatment of moderate to severe vulvovaginal symptoms

The risks of hormone therapy differ depending on type, dose, duration of use, route of administration, timing of initiation and whether a progestin is used, Dr. Jacobson explains. Risks of systemic estrogen therapy alone and combination estrogen and progestin include increased risk for venous thromboembolism and gallbladder disease. Additionally, she says, the combination estrogen and progestin carries a rare but increased risk for stroke and breast cancer. Patients with a uterus who take estrogen without an adequate amount of progestin are at increased risk of endometrial hyperplasia and endometrial cancer.

While MHT is appropriate for many symptomatic women, Dr. Jacobson says that there are some contraindications that would rule out hormone therapy as a treatment for menopause symptoms. These include a history of an estrogen-sensitive cancer (like breast cancer), coronary heart disease, heart attack, stroke and venous thromboembolism or inherited high risk of thromboembolic (blood clotting disease).

If you have one of these contraindications but are still looking for relief from menopause symptoms, dont fret; Dr. Jacobson tells me that there are a number of other medications that can help with symptoms, including the antidepressantsparoxetine (Brisdelle) and Venlafaxine (off-label), which provide mild to moderate improvements in vasomotor symptoms. Also, Gabapentin is associated with improvements in the frequency and severity of vasomotor symptoms. Fezolinetant (VEOZAH) is a novel, non-hormonal medication which treats moderate-severe vasomotor symptoms. Fezolinetant modulates neuronal activity in the thermoregulatory center of the hypothalamus in the brain.

Additionally, Dr. Jacobson says folks can try the below non-prescription based methods to manage their symptoms.

For VMS:

For Vaginal Symptoms:

Over the counter vaginal lubricants (e.g., Astroglide, OMy, K-Y Brand, Liquid Silk, Yes!, Pjur, Pink, Wet Platinum)

Menopausal hormone therapy is one of a number of treatmentsin addition to lifestylechanges, supplements, integrative therapies and prescription medicationsthat can ease vasomotor, vaginal and mood symptoms associated with menopause. While its helpful to read up on your options, only you and your doctor can determine what course of action is right for you.

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Everything You've Ever Wanted to Know (But Were Scared to Ask) About Menopausal Hormone Therapy - AOL