Menopausal hormone therapy

As your periods become less frequent and eventually stop, you enter menopause. During this transition, your body produces fewer reproductive hormones, like estrogen and progesterone. These lower hormone levels can lead to uncomfortable symptoms like hot flashes, vaginal dryness, and insomnia. Hormone therapy, especially hormone replacement therapy (HRT), can help manage these symptoms by replenishing the body’s declining hormone levels.

Penn Medicine offers menopause care for women of all ages, including those experiencing perimenopause (in the years before menopause) and postmenopause (in the years after menopause). Our women’s health experts work with you to understand your symptoms and how they impact your daily life. Hormone replacements are often prescribed to help you feel better and improve your well-being.

Many women make the transition to menopause as a natural part of aging. You may also experience menopause because of surgery, such as removal of the ovaries, or other medical treatment. Regardless of how the hormonal shift occurs, menopause can affect you in many ways—including in the years leading up to menopause and long after your periods have stopped.

Common physical and emotional impacts include:

• Hot flashes and night sweats
• Insomnia
• Mood swings, including depression
• Vaginal discomfort, irritation, or dryness
• Weight gain
• Headaches
• Brain fog
• Urinary and pelvic floor issues

If these or other symptoms impact your daily routine, it’s time to talk with your doctor about treatment options. They may recommend lifestyle changes first, including diet, exercise, and stress management approaches. If these measures don’t bring relief, estrogen replacement is often prescribed.

While hormone replacement therapy for menopause and perimenopause is a safe and effective treatment for most people, your doctor will discuss any risks to consider. They’ll review your overall health, medical history, age, and severity of your symptoms to assess if hormone replacement is right for you.

Hormone therapy for women can take many forms, including pills, creams, and patches. It can include estrogen hormones only or a combination of estrogen and progesterone. The hormones used may depend on whether you have a uterus.

• Systemic hormone therapy can treat a wide variety of menopausal symptoms and is considered a whole-body treatment. It’s taken as a pill, gel, cream, spray, ring, or skin patch.
• Vaginal estrogen treatments are low-dose therapies used solely to treat vaginal dryness and urinary issues. It’s typically taken as a vaginal cream, tablet, or ring.

Some forms of menopausal and perimenopausal hormone therapy are taken for a limited time, while others, like vaginal estrogen, may be used for longer periods. Your doctor will create an individualized care plan and timeline for you after assessing the severity of your menopausal symptoms and any personal risks.

Menopausal hormone therapy has few immediate side effects and is usually well tolerated by most people. However, there may be risks of taking hormone therapy longer term, including stroke, blood clots, heart disease, and some cancers. You’ll be monitored by your care team to check any side effects and adjust your treatment plan if needed.

To reduce any risks of hormone replacement for menopause, your provider may recommend lowering the estrogen dose over time or using a different estrogen preparation, for example, using patches instead of oral medications to lessen the risk of blood clots. Regular physical exams, including breast exams and mammograms, may also be recommended.

Penn Medicine’s menopausal care is delivered by specialists in women’s health and informed by evidence-backed research in hormonal therapies. We provide comprehensive support and services for people experiencing perimenopause and menopause, considering their lifestyle goals, symptoms, and impacts on their day-to-day life. We listen to your concerns and create individualized care plans based on your unique health profile, recommending treatment options that help you get back to living your life with greater comfort.