Female Sex Hormones
The ovaries produce two important sex hormones in a woman: oestrogen and progesterone. The levels of these hormones decline dramatically after the menopause. The normal menopause begins around the age of 50 years in most women. Although most women can tell when the menopause begins, some women require blood tests to measure their hormone levels and confirm the menopausal state.
The decline of female sex hormones increases the risk of osteoporosis (brittle bones), heart diseases such as heart attack, and stroke. The skin also ages more quickly in the absence of these hormones, becoming more wrinkled and thin.
The menopause is characterised by the ceasing of menstrual periods, hot flushes, and vaginal dryness and discomfort. These symptoms are fairly mild and tolerable in most women, but in others they can be very severe and unpleasant. Hormone replacement therapy (HRT) should be considered to alleviate the symptoms of the menopause and reduce the risk of osteoporosis. HRT contains the female sex hormones oestrogen and progesterone.
Which HRT Should I Use?
Before being considered for HRT, it is important to ask the following questions.
Have You Had a Hysterectomy in the Past?
Hysterectomy is the surgical removal of the uterus (womb). Oestrogen can increase the risk of womb cancer when given on its own. So women who still have their womb should be given HRT containing both oestrogen and progesterone to reduce the risk of womb cancer. HRT containing both sex hormones is called combined HRT, such as Prempak-C. The oestrogen tablets and progesterone tablets may have to be taken on different days over a one-month cycle.
Women who have had a hysterectomy do not require progesterone and can use an HRT containing only oestrogen, such as Premarin.
Have You Ever Had a Blood Clot in the Leg Veins or the Lungs? Or Has Anyone in Your Family Had Blood Clots?
Women with a personal or family history of blood clots in the leg veins or lungs have an increased risk of these conditions if they start taking HRT. Caution should be exercised when considering HRT in such individuals.
Do You Have High Blood Pressure?
Caution should be exercised when considering HRT in women with high blood pressure, as HRT can cause fluid retention that would make matters worse.
Do You Have a Medical History of Any of the Following Conditions?
- Liver disease
- Heart disease
- Kidney disease
- Sickle cell disease
- Multiple sclerosis
Patients suffering from any of these conditions can take HRT with caution.