Menopausal Hormone THERAPY…That’s Right Folks It’s Therapy!
By: Holly L. Thacker, MD • Posted on June 03, 2012 • Updated May 24, 2023
Menopause - The Transition in Life
Menopause is the transition in life that occurs for all women (who live long enough). That is the transition from the “reproductive, menstrual phase” of life to the postmenopausal “period free” phase of life. This transition is medically, personally and hormonally an important phase of a woman’s life. Just as a high school graduate will never again be a high school student, a postmenopausal woman will never again ovulate. I have often said to my patients that menopause marks their entrance into their ‘second adulthood.’
Getting the Right Treatment for Menopause Symptoms
While menopause is a natural phase of life, it doesn’t mean it is worry free or without the need for reflection, assessment and sometimes medical intervention. Just as graduates pause to reflect on their high school careers as they begin the first phase of adulthood, which may include college, entering the workforce, and/or serving our country in the military, it is important for women and their physicians to reflect on menopause. Physicians should assess whether the woman is potentially estrogen deficient, which can have the following consequences:
- quality of life
- bone health
- skin and hair
- metabolic state
- genitourinary status
The Truth About the Risks of Hormone Therapy
That brings me to the absurdity of the U.S. Preventive Services Task Force statement that the risk of menopausal hormone therapy outweighs the benefits. That is true if you are only talking about women with NO symptoms and NO indications for menopausal hormone therapy. Duhh! Just like we don’t go around giving all women thyroid hormone preventively because 1 in 8 eventually will be low in thyroid; physicians only prescribe thyroid hormone to persons who are low in thyroid hormone.
So if a postmenopausal woman has enough hormones, has no symptoms, then there is no reason to preventively give her potent hormones. However, if she has symptoms because she is low in female hormones then the benefits of menopausal hormone therapy clearly outweigh the risks for mostly all women. Some women need:
- Systemic menopausal hormone therapy
- Local vaginal estrogen
- Simply to improve their lifestyle
So as you face your menopausal matriculation, be positive, optimistic, and do not be needlessly scared by headlines about the risks of hormone therapy.
For more information on menopause, download our free Menopause Treatment Guide.
Be Strong, Be Healthy, and Be in Charge!
-Holly L. Thacker, MD
About Holly L. Thacker, MD, FACP
Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Specialized Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Her special interests are menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health. Dr. Thacker is the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause.
- Surviving Menopause Series: Signs & Symptoms
- Menopause and Hot Flashes
- Perimenopause, Menopause and Depression
- Sex and Menopause
- Premature Ovarian Failure