Menopausal HRT
It is a stage in a woman’s life when she ceases to have menses. 12 months of absence of periods is required for a diagnosis of menopause to be made. The average age of menopause is 49.1 years with a mean of 45-55 years. Some women may experience it earlier than 40 years of age- this is called premature menopause seen in 1% of women. Menopause occurring after 55 years is late menopause.
With the life expectance of women increasing, the number of menopausal women is also increasing.
Menopause is divided into early menopause - <5years and late menopause - >5years since menopause.
- What are the common side effects of menopause?
- Hot flushes- sudden intense bout of bothersome sweating
- Abnormal bleeding patterns
- Weight gain
- Delayed metabolism
- Lipid abnormalities
- What are the genital and sexual side effects of menopause?
- Symptoms of estrogen deficiency in genitals- vaginal dryness, itching causing dyspareunia(pain with intercourse), frequent vaginal infections
- Lower urinary tract symptoms such as urinary frequency, urgency
- Vulvodynia or pain in the vulval region (female external genitals)
The genitourinary syndrome of menopause manifests by troublesome symptoms which makes sexual intercourse difficult. Not only estrogen, but testosterone levels also decrease. This causes a decreased sexual desire.
- What are menopause medications?
The supplementation of hormones given to menopausal women to overcome symptoms caused due to hormonal deficiency constitute menopause medications. These include
- Estrogen in the form of tablets to be swallowed, estrogen creams and gels to be applied locally
- Testosterone in the form of tablets to be swallowed or gels to be applied locally
- Natural products such as soy which have estrogenic property and are called phytoestrogens
- Other medications which can treat menopausal symptoms such as tibolone which have a positive influence on certain symptoms related to menopause.
- Are menopause medications safe?
When prescribed by experienced physicians at the right dose for the appropriate indication, they are safe.
Frequently Asked Questions
Menopause is generally confirmed after a woman has gone without menstrual periods for 12 consecutive months. The average age of menopause is around 49 years, although the timing can vary considerably between women. A menopause evaluation can help clarify whether your menstrual changes are part of the normal menopausal transition.
Menopause before the age of 40 is described as premature menopause and occurs in around 1% of women. Experiencing menopausal symptoms or loss of periods unusually early deserves medical assessment because the cause and appropriate management may differ from typical age-related menopause. Early menopause treatment should therefore be individualized.
Reduced estrogen during menopause can cause vaginal dryness and itching, which may make intercourse painful. Genitourinary changes can also make sexual activity difficult. Addressing menopause-related vaginal dryness may help manage these symptoms after appropriate evaluation.
Yes. Both estrogen and testosterone levels can decrease during menopause, which may contribute to reduced sexual desire. A decline in libido should not automatically be attributed to relationship or psychological factors; low sexual desire after menopause can have hormonal and physical contributors.
Hormonal changes during menopause can affect the genitourinary tissues, and urinary frequency and urgency may occur. Persistent symptoms should be evaluated rather than automatically assumed to be an infection. Urinary symptoms after menopause may have several possible causes.
Yes. Vulvodynia refers to pain in the vulval region and can occur among the genital and sexual effects associated with menopause. Persistent vulval pain deserves an appropriate assessment because vulval pain treatment depends on the underlying cause.
No. Hormonal treatment may address several symptoms associated with hormonal deficiency, including genital, urinary, and sexual symptoms as well as hot flushes. Whether menopausal hormone therapy is suitable depends on the individual's symptoms, health history, and medical assessment.
Estrogen creams and gels can be applied locally in addition to oral estrogen tablets. Local treatment may be considered when symptoms primarily involve the genital or vaginal tissues, but the appropriate form and dose should be decided by a qualified doctor. Local estrogen therapy should not be started without medical guidance.
Yes. Testosterone levels can decrease along with estrogen during menopause, and this hormonal change may contribute to decreased sexual desire. If symptoms suggest hormonal changes, a doctor can determine whether testosterone in menopause is relevant to the individual's treatment plan.
Yes. Menopause symptoms and their severity can vary considerably. Treatment options may include estrogen, testosterone, phytoestrogens, or tibolone depending on the individual's circumstances. The appropriate personalized menopause treatment should therefore be selected according to the woman's symptoms, medical history, and clinical needs.
