Hormone Therapy in Menopause

Hormone therapy in menopause is a medical treatment option planned to reduce some complaints arising from the decrease in estrogen levels. However, menopause management is not just about “should we give hormones or not?” It is not just a question.

During this process, hot flashes, night sweats, sleep disturbance, vaginal dryness, bone-joint pain, muscle cramps, weakness and mood changes should be evaluated together. Assoc. Dr. In Nazlı Korkmaz's approach, menopause treatment is a personalized process in which all the symptoms and general health status of the woman are addressed together.

In Menopause, Not Only Hormones, But Also Symptoms Are Considered

The symptoms experienced by every woman during menopause are different. While hot flashes and sweating are prominent in some women, sleep problems, bone pain, muscle weakness, forgetfulness, dry skin or vaginal complaints may be more prominent in others.

Complaints during menopause; Effects on age, menstrual cycle, comorbidities and quality of life should be evaluated together [1][3].

Therefore, it is not enough to just look at hormone levels when making a treatment plan. Complaints that affect the woman's daily life, examination findings, blood values, bone health and personal risk factors should be evaluated together.

The Relationship Between Bone Pains and Menopause

The decrease in estrogen levels with menopause can have an impact on bone density. During this period, some women may experience complaints such as bone-joint pain, back-waist pain, muscle weakness or tenderness during movement.

The decision on hormone therapy should be made taking into account personal risks, uterine condition, breast health, history of vascular disease, and expected benefit from treatment [1][2].

These complaints may not always be directly related to hormone deficiency. The risk of vitamin D deficiency, inadequate calcium intake, magnesium deficiency, thyroid problems, inactivity, or osteoporosis should also be evaluated.

Why Are Vitamin D, Calcium and Magnesium Important?

The balance of vitamin D, calcium and magnesium is important to maintain bone health during menopause. While vitamin D supports calcium absorption, calcium is one of the essential minerals in maintaining bone structure.

The treatment option for symptoms such as vaginal dryness, hot flashes or sleep problems is individualized according to the severity of the complaint and the patient's medical history [1].

Magnesium can be taken into consideration in terms of muscle functions, cramps and general mineral balance. For this reason, blood tests are performed when necessary, and if there is a deficiency, replacement treatment is planned under the supervision of a physician.

Treatment May Be Incomplete Without Replacing the Deficiencies

In a woman considering hormone therapy during menopause, accompanying vitamin and mineral deficiencies should also be reviewed. Because conditions such as vitamin D deficiency, calcium deficiency or magnesium deficiency; It can contribute to fatigue, muscle pain, bone tenderness, and decreased quality of life.

Bone health, cardiometabolic risks and gynecological examination findings should be monitored together in postmenopausal follow-up [2][3].

Therefore, menopause treatment should be holistic. The aim is not just to give hormones; The aim is to determine the missing values ​​in the body, to protect bone health and to make the woman feel more balanced.

Who May Be Suitable for Hormone Therapy?

Hormone therapy during menopause can be considered especially in women with prominent complaints such as hot flashes, night sweats, sleep disturbances and vaginal dryness. When making treatment decisions, age, time after menopause, presence or absence of a uterus, breast health, clot risk and cardiovascular diseases are taken into consideration.

Not every woman receives the same treatment. Assoc. Dr. Nazlı Korkmaz creates a personalized road map by evaluating the patient's complaints, examination findings and risk factors during the menopause process.

Treatment is Different for Women With and Without a Uterus

In women with a uterus, progesterone support may also be required, as giving only estrogen may affect the inner layer of the uterus. In some cases, only estrogen therapy may be considered in women who have had their uterus removed.

This distinction is important for the safety of treatment. For this reason, hormone treatment must be planned by a gynecologist and obstetrician and followed up with regular check-ups.

Vaginal Dryness and Local Treatments

During menopause, vaginal dryness, burning, pain during sexual intercourse and recurrent urinary tract complaints may occur. These symptoms can negatively affect quality of life and sexual health.

In this case, systemic hormone therapy is not always required. In some patients, local vaginal treatments, moisturizers or supportive applications may be sufficient. Treatment selection is made according to the severity of the complaint and the person's health condition.

How to Assess Bone Health?

Since bone density may decrease in the post-menopausal period, the risk of osteoporosis should be evaluated. Bone health should be monitored more closely, especially in women who have a family history of osteoporosis, have early menopause, are underweight, are sedentary, or describe frequent bone pain.

When necessary, bone mineral density measurement, blood tests and nutritional evaluation may be performed. Vitamin D, calcium and magnesium supplements should be tailored to the individual; Unconscious use of supplements should be avoided.

Lifestyle is Part of Treatment in Menopause

Lifestyle is as important as drug treatments in menopause management. Regular walking, weight training, balanced nutrition, adequate protein intake, avoiding smoking and quality sleep support bone health.

Even if hormone therapy or supplement support is planned, healthy management of the menopause process may become difficult without regulating the lifestyle. Therefore, the treatment plan should also include nutrition, exercise, sleep and stress management.

Are There Risks of Hormone Therapy in Menopause?

While hormone therapy has benefits, it also has risks that must be evaluated individually for each patient. Hormone therapy may not be appropriate for people with a history of breast cancer, unexplained vaginal bleeding, history of blood clots, certain cardiovascular diseases, or liver diseases.

For this reason, hormone therapy in menopause should not be started with hearsay information. The treatment decision should be made after examination, examination and personal risk assessment.

Menopause Treatment Should Be Planned Individually

During menopause, the aim is not only to replace the hormone deficiency. It is necessary to understand the symptoms experienced by the woman, evaluate her bone health, identify deficiencies such as vitamin D, calcium and magnesium, and improve her quality of life.

Assoc. Dr. With Nazlı Korkmaz, a personalized treatment plan can be created by evaluating hormone therapy, vitamin-mineral balance, bone health and lifestyle recommendations during menopause.

In summary

Hormone therapy in menopause may be an effective option in suitable patients; However, menopause management is not just about hormone therapy. Hot flashes, sleep problems, vaginal dryness, bone pain, vitamin D, calcium and magnesium deficiencies should be addressed together.

The best approach in this process is to make personalized planning with the evaluation of a specialist physician. If you have menopausal complaints, it is important to get a comprehensive gynecological evaluation rather than postponing your symptoms.

Frequently Asked Questions

Is hormone therapy necessary for everyone during menopause?

No. Hormone therapy is not applied to every woman. The severity of complaints, age, time after menopause and personal health risks are evaluated together.

Is bone pain normal during menopause?

Bone-joint pain may occur during menopause; However, these complaints must be evaluated. Vitamin D deficiency, calcium deficiency, magnesium deficiency or osteoporosis risk may be investigated.

Is vitamin D and calcium supplement necessary for everyone?

Support needs vary from person to person. Vitamin D, calcium or magnesium supplementation can be planned according to blood values, diet, bone density and physician evaluation.

Is a blood test alone sufficient for menopause?

No. Although blood tests are important, complaints, examination findings, bone health, lifestyle and personal risks should be considered together in menopause evaluation.

Does hormone therapy support bone health?

In suitable patients, hormone therapy may help reduce postmenopausal bone loss. However, vitamin D, calcium, exercise and regular monitoring are also important for bone health.

References

• [1] NICE NG23 - Menopause: identification and management- Clinical guide to menopausal symptoms, hormone therapy and follow-up approach.
• [2] ACOG - Clinical Guidance: Menopause- Clinical resources on menopause, hormone therapy and women's health.
• [3] WHO - Women's health- Women's health and preventive health approach according to life periods.