When a woman goes through menopause, her ovaries stop working (they stop making eggs), and she stops having periods. It usually happens to women between the ages of 45 and 55. If a woman hasn’t had her period for more than a year, she is said to be “post-menopausal.” The average age of menopause in Malaysia is 52. (between 45 to 55 years old).
During menopause, the amount of the hormone estrogen goes down. This leads to menopausal symptoms like hot flashes, joint and muscle pain, trouble sleeping (insomnia), memory loss, anxiety, vaginal dryness, tiredness, irritability, and vaginal dryness. In 80% of women, these symptoms would disappear after two years.
Hormone Replacement Therapy
HRT stands for hormone replacement therapy.
There are two kinds of hormone replacement therapy: estrogen and progestin (a hormone similar to progesterone). Estrogen’s job is to ease the symptoms of menopause. At the same time, progestin keeps the uterus from growing too much or getting cancer when estrogen is taken. Estrogen therapy is all they need to do for people who have had their uterus taken out.
What are the pros and cons of taking hormones?
One of the best things about HRT is that it makes life better overall. Some menopause symptoms are more emotional than physical, while others are less emotional and more physical. With HRT, these symptoms will go away. A survey showed that many people think HRT improves their lives, and some want to keep taking it for a long time.
Taking HRT can also help prevent osteoporosis, which is a big plus. During menopause, a woman loses about 0.5% of her bone mass every year, on average. By the time a woman is 80, she could have lost up to 30% of her bone mass. This makes her more likely to break a bone because of osteoporosis. But some medicines can be used to treat osteoporosis (see osteoporosis)
Side effects of Hormone Therapy
Depression: HRT may help some menopausal women feel less depressed, but anti-depression drugs work better when given together (see Depression)
Not being able to sleep (insomnia): This could be because of hot flushes, which make you sweat and feel uncomfortable. HRT is beneficial for women who have hot flashes.
Possible benefits also include putting off the start of dementia or Alzheimer’s disease.
Some risks come with using HRT. The Women’s Health Initiative (WHI) study, a prominent trial with many sites, found some risks. Some of these are slightly more likely to get heart disease, a stroke, or breast cancer. But many of the women in the study are overweight and smoke. Also, the average age is 60, and some women don’t start HRT until a few years after menopause. The risk is also primarily due to the progestin (proxy progestogen) being used since patients who are only on estrogen (because their uterus was taken out earlier) do not have a higher risk of heart disease.
Who should use HRT, and for how long?
HRT should be given to most women unless there is a reason not to. HRT should be given to women with vasomotor symptoms of menopause. Most experts think HRT, by and large, is safe and has more benefits than risks. Most of the time, your doctor would tell you to take it for up to 5 years. This is because taking it for more than five years slightly raises the risk of heart attack. To keep the vasomotor symptoms from returning, your doctor may slowly lower the dose of HRT before stopping it together.
Another group of women who should take HRT is those who went through or will go through menopause before they turn 45. Those with ovaries surgically removed at a younger age will also need HRT until age 50 or longer if the patient wants it.
Who shouldn't use HRT?
HRT is not a good idea for people who:
- Myocardial infarction (a heart attack) or coronary heart disease in your family history or if you have had one.
- History of a blood clot or a stroke
- Women at risk of the above may still be able to use HRT if they want to, even if they have had breast or endometrial cancer in the past that is now considered cured. In this case, you should talk to your Gynecologist.
Why should I choose Nexus Clinic for Shockwave Therapy?
Before starting an HRT, you should check in with your doctor or Gynecologist. A checkup should be done, which includes a mammogram, an ultrasound of the pelvis, and a blood test. A suitable HRT would be started based on how well you fit and what you want. After that, the doctor may want to see you again in a few months to see how the HRT works for you. Once you are happy with the HRT, you only need to check in once a year.
Alternately, you may book an appointment at one of our clinics in:
Nexus Clinic Kuala Lumpur
LG 10, Lower Ground Floor, Wisma UOA II, Jalan Pinang, 50450 Kuala Lumpur, Malaysia.
Mobile: 016-921 5699 / 016-702 5699
Landline: 03-2163 5699
Nexus Clinic Cyberjaya
P05-3A, P05-5, Shaftsbury Square, Jalan Impact, Cyber 6, 63000, Cyberjaya.
Mobile: 012-392 5569
Landline: 03-8322 5699
*The above pictures are for illustration purposes only. Your results may vary.
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