MenopauseRx wants you to know about recent studies related to Hormone Therapy

Did you know that vasomotor symptoms (hot flashes and night sweats) might last much longer than previously thought? This may impact the length of time many women will consider using hormone therapy.

Questions Posed by New Research:

Q: If I elect to use hormonal therapy for my symptoms... how long will I need to be on them and how should I discontinue them?

A: Although the answer to this question is difficult, a recent study by Cole, with 13 years of data on 438 women, found that the average length of symptoms lasted 5-6 years. This is a much longer duration than many clinical guidelines estimate symptoms to last. Most current guidelines mention that symptoms may last 6 month to 2 years.

Hot flashes and night sweats may adversely affect quality of life and the daily activities of women during the menopausal transition. Hormone therapy is an effective therapy, although research has not identified a recommended length of time to administer hormone therapy.

If you choose hormone therapy for relief of menopausal symptoms, MenopauseRx follows the guidelines suggested by the American College of Ob/Gyn and the North American Menopause Society, which include the following:

• Take hormone replacement therapy for the shortest possible time that works for you, in the smallest effective dose.

• Have regular consultations with your physician - at least once a year - to review your reasons for taking hormone therapy.

• Get regular gynecologic and breast cancer exams and periodic mammograms. Discuss with your health care provider how often to obtain a mammogram.

Here is a Newsflash from this same study: The duration of hot flashes was reduced by regular exercise - more exercise = shorter symptom duration! Yet another reason to exercise your way through menopause.¹

Because symptoms last much longer than originally proposed, the role of topical estrogen therapy is being researched for better symptom control using lower doses. Because topical estrogen (in the form of patches, lotions or gels) is delivered through the skin and does not have to go through the liver, researchers have noticed the potential for less risk of thrombosis (blood clots). Click here for more infromation on this topic.

Q: If I decide to stop using hormone therapy, how should I stop the medication?

A: Another study of over 800 women, by Haskell, was based on the lack of guidelines regarding the optimal way to discontinue hormone therapy. In this study 75% of the women stopped "cold turkey" and the remaining 25% tapered their use of hormone therapy. Tapering was significantly associated with lower menopausal symptom scores after discontinuation than the "cold turkey method". Also, tapering was associated with resumption of hormone therapy at a later date.²

The conclusion from this study would suggest that slowly tapering your hormone therapy, under the direction of your health care provider, might allow an easier transition with fewer menopause symptoms.

When choosing hormone therapy it is important to choose a treatment that allows a variety of dosing options. If the need to resume estrogen therapy after tapering, one can easily titrate back to lowest effective dose... thereby, using the lowest amount of hormone for the shortest duration of time... in line with current guidelines of hormone therapy use by ACOG.

Estrogen patches (such as Vivelle Dot) are available in a wide dosage range, which allows for very effective titration of the dose of estrogen. Many doctors have found that this dosage flexibility is very helpful, as "one size does not fit all" for the majority of menopausal patients.

1. Col, et al. Duration of vasomotor symptoms of middle-aged women: a longitudinal study. Menopause: Journal of NAMS. Vol. 16, No. 3, pp 453-457.

2. Haskell, et al. Discontinuing postmenopausal HT: an observational study of tapering versus quitting cold turkey: is there a difference in recurrence of menopausal symptoms?