The most widely used and best known form of hormone replacement is the oral, or tablet form and most of the research on this form of therapy has been done using this formulation. Most women who take hormone replacement are happy to take tablets of estrogen and progesterone on a cyclic basis, in much the same fashion that oral contraceptive pills are taken. Hormone tablets can be taken according to many different time and dosage schedules. Your physician will work with you to determine the appropriate timing and dosage for you, depending on your response to treatment and, to a certain extent, on your lifestyle.
One of the most important things to understand about this treatment is that you still have a uterus - that is, if you have not had a hysterectomy (surgical removal of the uterus) - you make the progesterone in addition to estrogen for at least ten to twelve days out of every calendar month. This will ensure regular monthly bleeding.
Every hormone replacement therapy should cater to the individual needs of different women. A lot of older post menopausal women stop this form of therapy because they don't want monthly menstrual bleeding. This is a pity, as designer therapies can reduce or completely eliminate menstrual bleeding and immensely reduce your risk of developing cancer of the uterus. In fact, there is less of a risk of this type of cancer in menopausal women on a combination hormone replacement than there is in women who take no hormone replacement at all.
Some menopausal women feel better having a five-day break from estrogen, but if you don't, there is no harm in taking estrogen every day. In fact, taking estrogen every day is better for your bones and blood vessels. There is no risk, provided you also take your progesterone tablets for at least twelve days of each calendar month.
Nowadays, menopausal women are often prescribed both estrogen and progesterone tablets to be taken every day without a break, which completely eliminates menstrual bleeding. If any spotting or breakthrough bleeding occurs during the course of treatment, you may take a seven-day break from estrogen and progesterone tablets every three months. This will enable your uterus to shed any built-up lining in the form of a light menstrual period. Most menopausal women on this treatment feel more comfortable having menstrual bleeding every three months or so, seeing it is a kind of "cleaning" for the uterus, after which they often feel better.
If you are a post menopausal women over the age of sixty-five and it is deemed necessary for you to begin taking hormone replacement to slow the progression of osteoporosis, it is advised to take a small dose of estrogen continuously with no breaks at all. In such cases, light menstrual bleeding can be brought on only two or three times a year by the addition of a two-week course of progesterone tablets. This reduces the occurrence of regular monthly bleeding. There are several combination formulations of the two sex hormones estrogen and progesterone, which can be taken in every day without a break, eliminating menstrual bleeding completely.
Michael Russell
Your Independent guide to Menopause | |
