Are there any benefits of sex hormones in post-menopausal women?

Yes, definitely there are some benefits. There are a variety of synthetic and non-synthetic hormones available. These hormones are only available with a doctor’s prescription. There are natural products available in health food stores without a prescription but the quality of these hormones is unknown and unregulated.

These hormones do have some benefits when taken for short periods and when closely followed by a healthcare provider. The sex hormones may provide protection against the following medical disorders:

- Osteoporosis. There are many studies, which show that the bone thinning that occurs after menopause can be prevented by sex hormones. By increasing bone density, there is also a decreased incidence of hip fractures.

- There is new evidence that these sex hormones may lower the risk of colorectal cancer. However, taking sex hormones for long periods is also associated with a risk of other cancers.

- Prior to menopause, women have a much lower risk of heart disease. This is due to the protection provided by the sex hormones. After menopause, women have declining levels of the sex hormones and their risk of heart disease quickly rises to the same levels as men. It is now known that estrogen at low doses when taken early in menopause may help maintain the low risk of heart disease.

Post-menopausal women are usually prescribed a combination of estrogen and progesterone. The reason for this is that estrogen alone increase the risk of uterine cancer, whereas the addition of progestin counters the risk. Any female who wishes to use sex hormones after menopause should speak to a knowledgeable physician and assess the pros and cons about this therapy.

Why is there so much fuss about hormonal therapy after menopause?

Up until the late 1990s, physicians freely prescribed hormones to post-menopausal females. It was believed at that time that these hormones were safe. In fact, these hormones helped relieved the symptoms of menopause in the majority of females. Hormonal therapy was a universal standard for the treatment of hot flashes and there was evidence that these agents could even prevent osteoporosis.

However, in the last decade several large studies show that empirical use of these sex hormones is not good for health. In fact, most studies show that long-term use of the hormones after menopause cause more harm than good. There is a strong belief that prolonged use of these agents may increase the risk of breast and uterine cancer. Today, most health professionals are extremely reluctant to prescribe these hormones to post-menopausal women.

What causes symptoms of menopause ?

Is it just the hormones?

The basic cause of menopausal symptoms is the decline in sex hormones. However, there are other physiological changes that are responsible for the elevated temperature, sweating and flushing. It is believed that certain parts of the brain which are responsible for maintaining body temperature and sweating go awry when the sex hormones decline. It is the sex hormone, estrogen, which is primarily responsible for most symptoms of menopause.

However, there is not strict correlation between low levels of estrogen and hot flashes. The reason is that many young girls and adolescent women have low levels of estrogen from a variety of causes but they do not develop symptoms of menopause. It appears that estrogen may be the trigger factor during menopause and may interact with other hormonal systems.





Are there any risk factors which can worsen symptoms of menopause?

Yes, there are definite risk factors which can worsen menopause. Not all women have the same intensity of symptoms and thus it is believed that certain risk factors tend to make symptoms worse. These risk factors include?

Research indicates that women who smoke are more prone to developing hot flashes and other symptoms of menopause. Moreover the symptoms tend to be more intense and prolonged in smokers.

Obese women are also more prone to hot flashes and other symptoms of menopause. In addition, the symptoms are also prolonged and generally do not always respond to hormonal therapy.

Women who tend to live sedentary life styles are also more likely to experience menopausal symptoms. Most athletic women and those who exercise regularly tend to develop symptoms that are of mild duration and easily tolerated.

It is also well known African American women have more severe symptoms of menopause those other ethnic groups. Hot flashes tend to be less common in Orientals like Japanese and Chinese in comparison to Caucasians.

The Benefits of Sex Hormone Therapy?

Menopause is an agonizing time for most women. With declining levels of the sex hormones, a great majority of women develop symptoms like vaginal dryness, dry skin, hot flashes, depression, itchiness, difficulty sleeping and even weight gain. While there is no satisfactory therapy, most physicians do recommend a short course of estrogen and progesterone. Estrogen is very effective for the treatment of menopausal symptoms and is available in many formulations. It can be taken orally, applied as a patch on the skin, used as a cream format, injected or even be placed directly into the vagina as a suppository. Within a short time, most women find relief from the above symptoms. When used on a regular basis, estrogen can also ease symptoms of vaginal dryness during intercourse.

However, long term treatment with sex hormones is not recommended. The reason is that there is a lot of evidence that use of sex hormones for more than 3-5 years can lead to development of breast or uterine cancers. However, when these hormones are taken for short term they do have certain benefits like:

Osteoporosis. There are many studies that have shown that hormonal therapy can help prevent bone loss and improve bone density. The benefits on bone can be seen with fewer fractures and decreased pain within one to two years.

There is some evidence that hormone therapy may also help prevent colorectal cancer. While this is not a universal observation anecdotal reports show that some women who have been on these hormones have a much lower incidence of such cancers.

Regular consumption of female sex hormones is known to decrease fats and cholesterol levels and decrease the risk of heart disease. The studies do show that sex hormones when taken early during menopause can help decrease the risk of heart disease and stroke compared to women who do not take these hormones.

In menopause, estrogen is should not be prescribed alone. This is because estrogen alone can increase the risk of uterine cancer. Thus most formulations also contain a low dose of progesterone or there is a separate cream of progesterone to take at the same time..

Whether to take a bioidentical hormone or the conventional synthetic hormones is a personal choice. However, bioidentical hormones are much safer because they are derived from natural plant sources and then synthesized in a laboratory. Synthetic hormones have been studied in 2002 by the Womens Health Initiative and shown to cause all sorts of serious problems for women such as stroke and breast cancer.