Menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT), is a medical treatment that involves the use of hormones to relieve symptoms associated with menopause. Menopause is a natural biological process that occurs in women usually in their late 40s or early 50s, marked by the cessation of menstrual periods and a decline in reproductive hormones like estrogen and progesterone.
Menopausal hormone therapy typically involves the administration of one or a combination of hormones, such as estrogen and progesterone, to alleviate symptoms like hot flashes, night sweats, vaginal dryness, and mood swings. It's important to note that MHT is not a one-size-fits-all solution, and the choice of hormones and their dosage may vary based on individual needs and health considerations.

​

There are two main types of MHT:

• Estrogen Therapy (ET): This is usually prescribed for women who have undergone a hysterectomy (removal of the uterus). Estrogen can be administered in various forms, including pills, patches, gels, creams, or vaginal rings.

• Combined Estrogen-Progesterone Therapy (EPT): This is recommended for women with an intact uterus to reduce the risk of endometrial cancer. EPT includes both estrogen and progesterone. Progesterone is added to counteract the potential overstimulation of the endometrium (lining of the uterus) by estrogen alone.

​

The North American Menopause Society (NAMS) is a leading organization that provides information and guidance on menopause and related issues. NAMS offers recommendations and guidelines for menopausal hormone therapy (MHT) based on the latest research and expert consensus.

 

Here are some key points according to NAMS:

• Individualized Approach: NAMS emphasizes the importance of an individualized approach to MHT. Each woman's experience of menopause is unique, and decisions about hormone therapy should be based on her specific symptoms, medical history, and personal preferences.

• Symptom Relief: MHT is considered the most effective treatment for managing moderate to severe menopausal symptoms, such as hot flashes, night sweats, vaginal dryness, and mood swings.

• Timing of Initiation: The timing of MHT initiation is a crucial factor. NAMS recommends that for women aged 50 or younger, or within 10 years of menopause onset, the benefits of MHT generally outweigh the risks when used for symptom management. For women over the age of 60 or more than 10 years past menopause, the risks may outweigh the benefits, and alternative options should be considered.

• Type and Form of Hormones: NAMS provides guidance on the type and form of hormones to be used. For women with an intact uterus, combination therapy with estrogen and progestogen is recommended to reduce the risk of endometrial cancer. For women without a uterus, estrogen alone may be appropriate.

• Dose and Duration: NAMS suggests using the lowest effective dose of hormones for the shortest duration needed to manage symptoms. Periodic reevaluation with a healthcare provider is important to assess ongoing benefits and risks.

• Non-Hormonal Alternatives: NAMS acknowledges that MHT may not be suitable for all women or may not be their preference. Non-hormonal alternatives, including lifestyle changes, cognitive-behavioral therapy, and certain medications, can be considered for symptom management.

​

It's essential for women to have open and informed discussions with their Doctor about their menopausal symptoms, overall health, and individual risk factors before considering MHT. Decisions about MHT should be made collaboratively, taking into account the woman's preferences and the most up-to-date medical evidence. Regular follow-up visits with the DB GLOW healthcare team are recommended to monitor the ongoing appropriateness of MHT for each individual.