Menopause Hormone Therapy (MHT)
Estrogen plays such an important role in maintaining bone.
Menopause Hormone Therapy (MHT) with estrogen and progesterone, is commonly used to relieve the symptoms of menopause. Because estrogen plays an important role in maintaining bone, MHT is another option to consider to treat osteoporosis if you are also seeking relief from symptoms of menopause.
How Does Menopause Hormone Therapy Work?
Following menopause, the body produces much less of the sex hormones estrogen and progesterone, resulting in a loss of bone density. Estrogen/progesterone treatment is not intended to “replace” the loss of these hormones, but to supplement these hormones to the lowest level required to prevent bone loss. Treatment can consist of estrogen alone (in women without a uterus) or estrogen and progesterone in combination.
How Effective is it?
Estrogen/progesterone treatment prevents spine and hip fractures and can maintain bone density.
Who Can Take It?
Estrogen/progesterone is used to treat osteoporosis in postmenopausal women who are also experiencing menopausal symptoms such as hot flashes and night sweats.
How is it Taken?
A dose of 0.625 mg of oral conjugated equine estrogen (or its equivalent) is taken each day. Unless you have had a hysterectomy, progesterone is also taken to reduce the risk of developing uterine cancer. Estrogen/progesterone are available in both pill and patch form and in a variety of regimens. Estrogen is taken either transdermally (as a patch or a gel) or orally as a pill. Unless you have had a hysterectomy, progesterone is also taken to reduce the risk of developing uterine cancer. There are several formulations and regimens of estrogen and progesterone that are available.
Are There Side Effects?
Side effects can include headaches, breast tenderness, premenstrual syndrome, skin irritation and weight gain. Menstrual bleeding may also occur. Experimenting with doses, types (pills, patches) and regimens may help to eliminate (or minimize) these side effects.
It is important to have a discussion of the risks and benefits of menopause hormone therapy with one’s healthcare provider before starting menopause hormone therapy. Risks to discuss include increased risk for breast cancer, stroke, and venous thromboembolism (blood clots).
The risk of endometrial cancer is increased if estrogen is used without progesterone; however, this risk is minimized by the addition of progesterone for women with an intact uterus.
Using menopause hormonal therapy just for bone health is not usually the first choice. Usually menopause hormonal therapy is considered if there are also other reasons to take it, such as menopausal symptoms.