Many women experience physical and emotional changes during menopause, but treatment options are available to help manage symptoms and improve quality of life, according to Drs. Catherine Lavender and Savannah Giovane, clinical professors in the CCHS Department of Family, Internal, and Rural Medicine.
They discussed a treatment option called menopause hormone therapy (MHT) during a recent presentation to faculty, residents and medical students at the College of Community Health Sciences, which operates UMC.
MHT, which is available at UMC, uses hormones, such as estrogen and progesterone, to help manage menopause symptoms and address health concerns associated with hormone changes. Through education and clinical training, CCHS providers, residents and medical students are learning current approaches to evaluating menopause symptoms, discussing treatment options and providing evidence-based care.
Menopause is a natural stage of life for women reached after 12 consecutive months without a menstrual period. Symptoms can begin before menopause and vary widely among women, ranging from mild changes to symptoms that affect daily life.
“There is no one menopause syndrome,” Lavender said, explaining that every person’s experience with menopause can be different. Common symptoms include hot flashes, night sweats, sleep disturbances, mood changes and cognitive changes often described as brain fog. Some patients may also experience genitourinary symptoms, including vaginal dryness, irritation and urinary concerns.
Lavender said treatment decisions should be individualized based on a patient’s symptoms, health history and personal preferences. Lifestyle changes, counseling and non-hormonal medications may help some patients manage symptoms, while MHT remains the most effective treatment for moderate to severe symptoms, including hot flashes and night sweats.
“Hormone therapy is not one-size-fits-all,” Giovane said. “Treatment should always be based on an individual’s symptoms, health history and goals.”
Research on MHT has continued to evolve, helping physicians better understand when the treatment may provide the greatest benefit with the lowest risk. For many healthy patients, MHT is considered safest when started before age 60 or within 10 years of menopause.
How hormone therapy is administered is also important. Patients who still have a uterus and receive estrogen therapy generally need progesterone to help protect the uterine lining. Transdermal estrogen options, such as patches, gels and sprays, may be preferred because they bypass the liver and may lower the risk of blood clots compared with oral forms. For patients experiencing vaginal dryness, irritation or other symptoms related to genitourinary syndrome of menopause, low-dose vaginal estrogen can provide effective relief with minimal absorption into the bloodstream.
Lavender and Giovane also reviewed situations where MHT may not be appropriate, including when patients have certain cancers, advanced liver disease and a history of blood clots. They emphasized that menopause care requires ongoing conversations between patients and their health care providers to weigh the benefits and risks of treatment and to determine the best approach.