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Menopause symptoms: Surviving the change

​​​​​​​​It is a bit of a conundrum. Prolonged annoying menopause symptoms may cause health problems, but research has shown that hormone replacement therapy (HRT) to relieve symptoms may have potential health risks. 

three womenWhat is right for you? Talk with your doctor to make the best choice for you.

Menopause symptoms usually begin around age 50 to 55 and may include hot flashes, anxiety, trouble sleeping, vaginal dryness and painful intercourse.

"It's hormonal," said Family Medicine Physician Diane Hrdina, ​M.D.​, Marshfield Clinic Eagle River Center. "Your ovaries are beginning to no longer produce estrogen, a female hormone. Some women aren't bothered by the symptoms. For those who are, it's a good idea to talk with your doctor to learn about options for treating."

Menopause can occur naturally with the ending of the menstrual cycle or if the ovaries are removed during surgery for medical reasons.

"Previously doctors would prescribe HRT for every woman experiencing menopause symptoms in an effort to also protect her from heart disease," said Dr. Hrdina. "Research has changed that thinking, and the thinking is still evolving. If you are age 50 to 59, depending on your medical history, your doctor may recommend HRT to help manage menopause symptoms only."

Estrogen is the hormone being replaced with HRT. It is the same estrogen taken in birth control pills except at a lower strength. Taking estrogen does increase the risk for blood clots.

"Because the strength of estrogen in HRT is much less than in the pill, the risk for blood clots with HRT is quite low," said Dr. Hrdina. "For thin, healthy women, it is very minimal."

Women who have a family or medical history that includes risk for heart disease or stroke, HRT is not recommended. "Age also is a factor in whether to recommend HRT," Dr. Hrdina said. "Because risk for heart disease and stroke increase with age, you and your doctor may need to consider treating symptoms independently, such as using a vaginal cream or other topical product."

A thorough discussion of your medical history with your doctor is a good first step, said Dr. Hrdina. "Conditions such as vascular disease, stroke, blood clot, breast cancer, diabetes, high cholesterol, high blood pressure or high blood sugars that are not diabetes -- all are indicators to not prescribe HRT," she said. "When your medical history warrants, or if you are concerned about risk factors, safe alternatives to HRT are available for symptom relief."

Research continues on the benefits and risks of HRT and the connection estrogen loss has to heart disease in women. "This is a big decision for women," said Dr. Hrdina. "It's not as simple as what to take, in what form and for how long. It is about you and your doctor deciding what is right for you."