Ask The Nurse

To personally discuss a medical issue or to make an appointment, call 216-444-4HER (216-444-4437). You can also make an appointment at Cleveland Clinic. For your security, please do not use this form to email personal, confidential health information. We cannot diagnose or treat by email. Our email policies are explained further in this disclaimer. You may also wish to review our privacy statement. Disclaimer | Privacy

I was on hormone therapy for 5 years, but stopped 6 weeks ago because of bleeding. An ultrasound revealed no problems, so my doctor suggested HRT could be the culprit. I did stop bleeding after stopping HRT, but my menopausal symptoms seem to worsen with time. Hot flashes have increased and I am having trouble sleeping, which has never been a problem for me. I am also irritable and feel like crying a lot of the time.

I am 57 and do have a family history of heart disease and strokes. I also have a genetic mutation called MTHFR which can increase the chance of developing clots. Are there any alternatives to HRT that might help my symptoms? Thank you.

Yes, there are non-hormonal options for hot flashes like Brisdelle (paroxetine 7.5mg) taken daily at night.

If you have the MTHFR mutation, you should be on methylated folate (L-methylfolate) and have your B12 level checked. Just because you have the MTHFR mutation does NOT mean you can’t take menopausal hormone therapy. There is also transdermal patch hormone therapy that has a lower risk for clot.

Please see a menopause specialist to discuss all your options.

All My Best,
Speaking of Women’s Health nurse

March 24, 2017 at 4:30pm

Share this article


Go back to the question archive