Hormone Therapy


By: Ruchi Mathur, MD

What is menopause?

Menopause is the stage in a woman's life when menstruation stops and she can no longer bear children. During menopause, the body produces less of the female hormones, estrogen and progesterone. After menopause, the lower hormone levels cause the monthly menstrual periods to stop and gradually eliminate the possibility of becoming pregnant.
These fluctuations in hormone levels can also cause troublesome symptoms, such as hot flashes (a sudden sensation of warmth, sometimes associated with flushing, and often followed by sweating) and sleep disturbance. Sometimes women experience other symptoms, such as vaginal dryness.

While many women encounter little or no trouble during menopause, others endure moderate to severe discomfort.

Does menopause cause bone loss?

The lower estrogen levels of menopause can lead to progressive bone loss that is especially rapid in the first five years after menopause. Some bone loss in both men and women is normal as people age. Lack of estrogen after menopause adds another strain on the bones in addition to the usual age-related bone loss. When bone loss is severe, a condition called osteoporosis weakens bones and renders them susceptible to breaking. For more, please read the osteoporosis article.

What are estrogen therapy and hormone therapy (HT)?

Estrogen, in pill, patch, or gel form, is the single most effective therapy for suppressing hot flashes.

The term estrogen therapy, or ET, refers to estrogen administered alone. Because ET alone can cause uterine cancer (endometrial cancer) (see below), a progestin is administered together with estrogen in women who have a uterus to eliminate the increased risk. Thus, the term estrogen/progestin therapy, or EPT, refers to a combination of estrogen and progestin therapy, as is given to a woman who still has a uterus. This method of prescribing hormones is also known as combination hormone therapy.

The term hormone therapy (HT) is a more general term that is used to refer to either administration of estrogen alone (women who have had a hysterectomy), or combined estrogen/progestin therapy (women with a uterus).

All forms of hormone therapy (HT) that are FDA-approved for therapy of hot flashes are similarly effective in suppressing hot flashes.