Category Archives: Hormone Replacement Therapy

I am a 60-year-old woman at the end of a five-year regimen of hormone therapy. My doctor has advised me to eventually stop the use of estrogen and progesterone by this summer, as she says women have an advanced risk of breast cancer at this age. Another friend a few years younger than me was told by her doctor that she could continue with hormone-replacement therapy until she is 70. Which doctor is correct? I am experiencing constant hot flashes again and am able to snatch only little bits of sleep each night, along with all of the other issues that come with the loss of estrogen inability to regulate temperature, hair falling out, flaccid skin and vaginal dryness. My other question is, am I able to use other herbal compounds, specifically saw palmetto and/or St. Johns wort, without any risk of breast cancer? Or, are these and other estrogen-mimicking compounds also a contributor to breast cancer?

There is no one-size-fits-all answer to the first question about how long to continue hormone treatment for symptoms of menopause. I disagree with any absolute rule, such as stopping at five years or waiting until 70, because any woman may place a different value on her well-being, and a womans individual risk for breast cancer also needs to be considered.

You havent told me about any particular risk, but my answer would be very different for a woman with average risk compared with a woman with increased risk due to family history, for example.

About 40% of women will have symptomatic hot flashes until age 65, and continuing estrogen is reasonable in women who are willing to accept the increase in risk.

The risk is not just breast cancer. Women taking combined estrogens and progestins have a small increase in the risk of heart disease, stroke and pulmonary embolism, or blood clot to the lung, but a decreased risk of colon cancer and hip fracture.

That all sounds scary, but the increase in risk of any of these is less than 0.5%. Overall, women on combined hormones were slightly less likely to die than those who were not.

Many women choose to continue taking their hormones when their symptoms are significantly affecting their quality of life. I feel very strongly that its the physicians job to advise so a woman can make the best decision for herself.

Saw palmetto is not commonly used for menopausal symptoms its used very frequently by men with prostate issues and there is inconsistent evidence on its contribution for breast cancer.

Similarly, there is no consensus on the risk of St. Johns wort for breast cancer, and only limited evidence that it helps menopausal symptoms. St. Johns wort can interact with many medicines, so its wise to discuss its use with a pharmacist if you are taking other medication.

Many women ask about phytoestrogens, such as in soy protein or red clover, and other herbs with estrogenic activity, such as black cohosh.

There is a theoretical risk, and although there are some studies suggesting they may be safe, many experts advise against these for women at high risk. That group would include women with a history of an estrogen-sensitive tumor.

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To Your Good Health: Length of hormone treatment depends on the individual - Agri-News

Moving homes, new relationships, career prospects and summer holidays. These are some things you might be thinking about when youre in your 20s and 30s. What most people in this age range probably arent likely to be pondering, however, is the big change. It may be the furthest thing from your mind, but the reality is that menopause isnt a sudden condition that hits women once they reach their late 40s. Rather, its a gradual transition (calledperimenopause)and can start 10 years beforemenopause itself.

As many as 5% of the UK population will reach menopause earlier than the average age of 45-55, while 1% experience it earlier than 40. In your 20s, the likelihood is 0.1%. And the longitudinal US study SWAN showed that women from Black and other minoritised ethnic groups might experience menopause earlier than the average.

Theres certainly more awareness now of what can be distressing symptoms of menopause: increased anxiety, osteoporosis, insomnia and a slower metabolism. The earlier you start monitoring and recognising those symptoms, the more empowered you will be to seek advice and start a treatment plan to alleviate them and other long-term effects.

Most of us can usefully integrate diet and fitness tweaks, including more strength training to build muscle mass and bone density, which also helps prevent low hormone-related diseases and symptoms.

Some women have lots of symptoms; some women might only have one symptom and that symptom is enough to really impact the quality of their life, says GP and menopause specialist Dr Louise Newson, explaining there is no blueprint of how women experience perimenopause.

Some people may start feeling worse just before their periods more irritable and tired other people feel those days last longer. Some experiences will involve symptoms coming on very quickly with a sudden onset of mood, memory and sleep issues. Hot flashes and night sweats are commonly cited problems but not all women will experience these. However, some women will feel bad all of the time.

There are more unusual symptoms too, such as urinary symptoms, vaginal dryness, burning mouth, tinnitus, restless legs and itchy or dry skin. Symptoms may vary throughout the days as well.

Theres this misconception that women have to manage the symptoms, says Dr Newson. When women have symptoms, its a sign that their hormone levels are low. And that can be easily treated with hormone replacement therapy (HRT), which Dr Newson says is safe for the majority of women.

Taking HRT earlier can also reduce the risk of disease, says Dr Newson. But, as well as women empowering themselves with information, there should also be a wider acknowledgement that womens choice is largely being dismissed. Women have been refused HRT, for example, and given antidepressants instead.

Women are just being ignored, which has got to stop. Its 2022, says Dr Newson.

Women know their bodies; often, women understand whether their symptoms are due to their hormones or not. And if they think they are, then they absolutely should be taken seriously.

However, while a 1% chance of experiencing menopause before your 40s may seem like good odds, one in 100 women is actually a significant proportion, says Dr Newson: A lot of women are told theyre too young to be menopausal or perimenopausal for which no one is too young.

That is why its so important that women know when to get appropriate guidance from a healthcare professional. You really want to see your GP as early as possible, particularly once symptoms start affecting your quality of life.

But Dr Newson also says that moderating diet and exercise can assist with some of the health-related risks associated with having low hormone levels, as can looking at your sleep and mental wellbeing. Perimenopause is, therefore, a good time to take stock and consider how we live our lives and how it will affect our future selves.

Irina Allport, a personal trainer and nutritional coach, also recognises the benefit of reviewing diet and exercise practices during perimenopause and menopause, something she homed in on after watching her mum have a particularly tough time going through it.

She found that some of the best ways of looking after your health are to incorporate more fish, nuts, veggies, fruit and dairy into your eating plans.

Eat natural foods and stay clear away from anything that elevates your hormones coffee, booze or overconsumption of sugar. We want you to have a balanced body to help out with all the changes taking place, says Allport.

In addition, Allport advocates for eating soy foods, phytoestrogens or plant-based oestrogen that mimics the role of natural oestrogen in the body. Research suggests that eating phytoestrogen-rich foods (soy milk, tempeh, tofu, soy-linseed bread) may ease menopausal symptoms.

Supplements can form part of any regime. Allport says to consider:

Then theres exercise, which many say should include more resistance training and balance not just cardio.

Strength train. This is the best thing to do as we get older, says Allport. Strength training exercises will help to build bone and muscle strength, and rev up your metabolism. At home, opt for dumbbells and resistance bands.

Being more attentive to your diet and exercise can improve mood, balance hormones, sleep and energy levels and lower heart disease, diabetes and osteoporosis risks, says Allport, which are linked to low hormone levels. In addition, professionals say the younger you start these exercises, the more beneficial it is.

Equipment: set of dumbbells/1.5 litre water bottles

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How to eat and exercise for menopause: why you should prep now - Stylist Magazine

Melasma is a skin condition that frequently affects pregnant women and anyone who has spent too much time in the sun. Melasma can appear anywhere on your body where the skin is exposed to sunlight. In addition, hormonal imbalances in pregnant women or those taking hormonal birth control frequently cause melasma, which manifests as dark spots and colored patches of skin. This is sometimes referred to as the pregnant mask.

Melasma may occasionally be a symptom of malnutrition and poor liver health. Brown to gray spots on the neck, forearms, chin, above the upper lip, cheeks, forehead, or on the bridge of the nose are symptoms of this skin condition, which are challenging to treat. Melasma is more prevalent in women and might last even after giving birth.

Like other skin conditions, melasma can be treated with chemical peels, exterior lotions, laser therapy, skin protection, hormone replacement therapy, and dietary balancing. Before treating your melasma, speak with a dermatologist or medical professional. The following four simple steps include advice on improving and preventing melasma.

Consult a dermatologist or medical professional about your melasma. You will likely be recommended to take a blood test to look for nutritional deficiencies and impaired liver function that could be the root of this condition. Melasma could also be a negative side effect of your medication. Confirm this with your doctor.

Eat folate-rich foods. Melasma may result from folate or folic acid deficiency. Women on birth control, pregnant, or who consume an inadequate diet may have low B vitamin levels. Among the foods high in folate are whole grains, nuts, citrus fruits, and green leafy vegetables. Your doctor may also recommend you start taking a folic acid supplement.

Your diet should have a healthy balance of copper. Copper encourages the skins melanin production. Therefore, high levels of this mineral can result in excessive skin pigmentation. Copper should not be consumed separately if it is present in your multivitamin. Never exceed the daily copper recommendations of:

Consume foods high in vitamin C and iron, or take supplements of these nutrients to lower excessive copper levels.

Start eating more foods high in vitamins C and E. These antioxidant-rich foods aid in repairing skin damage from the UV rays, which can result in melasma. These vitamins are present in foods such as kiwis, blueberries, citrus fruits, nuts, vibrantly colored veggies, and fish. Before self-treating, have your melasma diagnosed by a professional.

Increase the number of raw fruits and vegetables in your diet to ensure you get enough vitamins and minerals. Avoid packaged and processed foods that have artificial chemicals and preservatives. Food sensitivities and allergic reactions can also cause inflammation in the skin, which can result in pigmented areas such as dark patches. It is also recommended to avoid inflammatory foods that can also contribute to skin inflammation.

Melasma, sun damage, and even skin cancer can be prevented by wearing sunscreen and avoiding damaging UV rays. You must visit your dermatologist or primary care physician if you detect melasma anywhere on your body.

Avoid taking too many nutrient supplements because they may have adverse side effects. Finally, dont discontinue taking prescription medications without consulting your doctor.

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How to Treat and Prevent Melasma with Nutrition - Intelligent Living

Although theres a lot that goes into finding the right partner, many find that a primary focal point in dating particularly in the early stages involves physical appearance. So, when you have a condition that can visbily affect your outward appearence, like alopecia, it can affect your self-eestem and confidence in the dating world.

Alopecia is the medical name for a everyday condition: "Alopecia is a general term to describe hair thinning or hair loss," Ken L. Williams Jr., DO, FISHRS, ABHRS, a surgeon and founder of Orange County Hair Restoration in Irvine, California. "The most common form of hair loss is due to genetics." Other causes of alopecia include thyroid issues, autoimmune problems, (known as alopecia areata), or in women, menopause. Men who use hormone replacement therapy may also experience hair loss.

Although hair loss can make you feel self-conscious about dating, the truth is, its incredibly common.

"Up to 50 percent of the adult male population has some type of hair loss," Dr. Williams says. But it's not just men who are affected: According to the Cleveland Clinic, more than 50 percent of women will experience noticeable hair loss as well.

Of course, the amount of hair loss or hair thinning you experience can also factor into your self-image. Some men (and women) have advanced balding to the point where they prefer to shave their heads. But as we age, hair thinning becomes more common, making it less of a stigma.

"Men and women in their fifties and sixties will not have the same type of hair density or frontal hairline as they did in their twenties or even their teenage years, says Williams. "So there is a natural appearance of hair loss as we age."

Even if its common, hair loss can still affect your self-confidence, especially if youre a younger person who is dealing with hair loss earlier than many of your peers. Further, if youre at a stage in your life where youre interested in dating or a starting a relationship, low self-image can become a barrier.

"Someone who is suffering from hair loss may have low self-esteem and might not have the self-confidence to ask an individual on a date, says Williams. It can also be challenging to style your hair or camoflouge the hair loss, which can impact your overall confidence.

These issues can also potentially lead to mood disorders. "Theres a known association between hair loss and anxiety and depression, as well as self-esteem and confidence; however, the subtle nuances have yet to be fully defined in medical literature," says Shani Francis, MD, MBA, a dermatologist and hair loss specialist based in Los Angeles. Dr. Francis has alopecia herself and experienced hair loss as a child. "Alopecias impact on self-esteem and confidence is real, diverse, and uniquely personal," she says.

Alopecia can be especially hard on women, who often face greater scrutiny and pressure about their physical appearance.

"There was a time I didnt want to go out of the house. I didnt want to wear a wig either," says Smriti Tuteja, a content writer in India who lives with alopecia. "Especially with women, when people want you to adhere to a certain standard, you assess your worth with that lens and end up being unkind to yourself," she says.

Hair loss doesnt have to derail your dating life in fact, it can be an opportunity to fully embrace every part of yourself and approach the scene with more confidence. Consider these tips:

If your hair loss bothers you or you want to camoflague it for whatever reason, you can talk to a hair loss specialist, such as a dermatologist, about options. "For some, that could include medical treatment or involve a wig, toupee, or new hairstyle, but for others both men and women it could also mean embracing a new image," says Francis.

If youre interested in exploring surgical options like a hair transplant, Williams recommends visiting the American Board of Hair Restoration Surgeons to find a qualified surgeon.

Above all, remember that youre not alone. "Hair loss affects millions of men and women, and there are countless support groups and professional organizations that advocate, research and support those who have alopecia," says Francis. These include the American Academy of Dermatology and the National Alopecia Areata Foundation.

Your hair loss is unique to you, and so is the way you want to handle it. But keep in mind that hair loss is only one aspect of who you are.

"Just because you've lost your hair doesn't mean you've lost who you are," says Gibson. "No one can duplicate your sensuality and sexuality that comes from within."

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4 Real-Life Dating Tips for People Living with Alopecia - Everyday Health

Main findings

Our results suggest that reproductive age (reflecting the menopausal transition) does not independently influence change in sub-clinical atherosclerosis (CIMT) or risk factors (e.g. SBP, non-HDL-cholesterol and triglycerides) strongly associated with atherosclerosis, as shown in randomised trials and/or Mendelian randomisation studies to causally influence coronary heart disease [17, 27, 28]. By contrast reproductive age may increase adiposity and risk of diabetes, albeit modestly, as suggested by stronger positive linear associations with reproductive age than chronological age for BMI, fat mass, and fasting glucose. HRT may not identically reflect endogenous hormonal and other changes associated with a natural menopause. However, it is notable that our findings have some consistency with randomised controlled trials of HRT, which have shown no protection, or a possible increased risk for coronary heart disease and reduced risk for type 2 diabetes [29].

To our knowledge, this is the largest prospective study to date with two repeat CIMT measures and up to four repeated cardiovascular risk factor measures that spans the late reproductive period, from menopausal transition into post menopause. The average 5-year follow-up period with up to four repeat measures in women of different baseline ages allowed the description of associations from 4years before to 16years after the menopause, a longer postmenopausal period than described in previous studies.

We used multilevel models, which allow all women with at least one measurement occasion to be included in the analysis under the MAR assumption, i.e. missingness depends on observed data and therefore associations do not differ in women (with the same characteristics) who have fewer repeat measures. Furthermore, sensitivity analysis restricted to women who had three or four repeat measures showed similar results to those with at least one repeat measure. We had to restrict our main analyses to women in whom we could calculate their FMP, meaning only those who has at least 12months since their last period could be included. This could introduce selection bias. However, consistency of our main analysis findings with those of the associations of change in outcome with chronological age by strata of menopausal status suggests our findings are not substantially biased by selection. We do however note that a womans menopausal stage will reflect her chronological age (i.e. at the time of baseline assessment, women who are pre-menopausal will be on average younger than those who are postmenopausal). We therefore need to be cautious in our interpretation and in the magnitude of associations which are likely to be driven by differences in the age distribution across the groups.

We fit models which included time since FMP and chronological age to separate the influence of both chronological and reproductive age. However, given that chronological age is the sum of age at menopause and time since FMP, we could have instead analysed time since FMP and age at menopause only, a reparameterisation of time since FMP and chronological age. As such, in mutually adjusted models, the coefficients of chronological age are equivalent to that of age at menopause, whilst time since FMP in the model including age at menopause is the sum of time since FMP in the model including chronological age and additionally the coefficient of chronological age.

As reproductive age is a self-reported measure and measured with more error than chronological age, it may be that this causes some bias towards the null for reproductive age, and correspondingly away from the null for chronological age.

Distributions of outcomes and confounders were similar between women included and excluded from the main analysis (Additional file 3: Tables S9S10).

Our study is predominantly of White European origin women, and previous studies have shown ethnic differences in cardiovascular risk factors [30], so our findings might not be generalisable to women of other race/ethnic groups. As our study recruited women during an index pregnancy and only followed those with a live birth from that pregnancy, all participants had at least one live birth and we cannot assume that our findings would generalise to women with no previous pregnancies or live births. As we know the risk of cardiovascular disease increases with an increase in live births [31], the association between reproductive age and cardiovascular health may differ in studies that also include nulliparous women. Vasomotor symptom severity and duration arealso known to associate with HRT use (the most effective treatment for these symptoms) and CVD risk. Censoring those who use exogenous hormones because we could not determine age at a natural menopause could induce some collider bias [32] if there is residual confounding between HRT and CVD. However, given the key confounders of HRT-CVD effects are the same as those for time to FMP and CVD (e.g. age, BMI, education) which we already adjust for, we anticipate that any bias would be small.

When restricting our sample to women with a time since FMP greater than 0, 71% of the sample, the median time (IQR) since FMP was 5.7years (4.28.8). We believe this time is long enough to observe any differences in CVD risks possibly related to the menopause. However, it may be possible that the longer women are followed up after menopause, evidence of associations become apparent, or the observed associations become larger in magnitude. Furthermore, given only 12% (203/1702) of the sample experienced early menopause, it is possible that women at the very low end of the age at menopause distribution are indeed at increased risk and we were not able to pick this up. These analyses are in unselected women in mid-life and only 20 (1.2%) had evidence of plaque or atherosclerosis, highlighting the need for further follow-up into older ages.

We were able to identify ten papers published up to December 2021 that either explored change in cardiovascular outcomes by reproductive age [8, 12, 15, 16, 33,34,35] or change with chronological age within strata of menopausal status [18, 36, 37]. We have summarised these in Additional file 4: Table S11 [8, 12, 15, 16, 18, 33,34,35,36,37] including number of women, number of repeated measures, sample characteristics and key results. With one exception, these included fewer than 500 women [18, 36, 37]. The one exception was the SWAN which included between 249 to 2659 women in different publications [8, 12, 15, 16, 18, 33, 35].

Only two of these explored associations with CIMT [16, 18]. El Khoudary et al. [18] included 249 participants, (122 premenopausal, 115 early peri-menopausal, 4 late peri-menopausal and 8 postmenopausal at baseline) and in line with our results found that CIMT increased in post-menopause (0.024mm/year, p-value 0.03) compared to pre-menopause, adjusting for age at baseline and ethnicity. Similarly, the recent SWAN paper [16] included 890 women with CIMT measures and suggested that older age at menopause was associated with an increase in CIMT.

Consistent with our results, Greendale et al., in a sub study of SWAN with N=1246 [15], found an independent association between reproductive ageing and gain in fat mass and loss of lean mass until 2years after the FMP in women who had an average age at FMP of 52years. Our findings, with larger numbers, add to this evidence in suggesting that reproductive age, independent of chronological age, increases body fat.

Unlike our findings, Derby et al. [8] found increases in triglycerides with reproductive age, having adjusted for chronological age; however, this change was small. As in our study, Matthews et al. [12] found increases in triglycerides in midlife were small and largely related to chronological age rather than reproductive age or menopausal status. A weak positive linear change in non-HDL-c with reproductive age, consistent with our results, was also shown in that study. In a previous analysis of the same cohort (ALSPAC) using a metabolomic and largely lipids platform, Wang et al. found important changes in many lipids across the menopausal transition, taking into account chronological age [11], however, data were available for only two time points.

Reproductive and chronological age were weakly positively associated with fasting glucose in our study whilst the SWAN studies found neither or a negative association [12, 33, 37]. However, our study was considerably larger than the others. Furthermore, the decrease with reproductive or chronological age would be surprising given in general populations diabetes increases with age [14].

Some studies have looked specifically at the association of early or premature menopause as a risk factor for CVD [38,39,40]. Daan et al. compared 83 women previously diagnosed with POI (i.e. loss of ovarian function before 40years of age) to 266 premenopausal women, all aged >45years, and found an association of POI with higher adiposity and higher CRP levels [40]. Similarly, Honigberg et al. in a study with 144260 postmenopausal women (natural or surgical menopause) found that premature menopause was associated with a small but increased risk for a composite of different CVD [38]. Our study, whilst analysing different parameters, has some consistency with those findings in suggesting that reproductive age associates with intermediate risk factors of CVD, such as adiposity and higher CRP and glucose levels, which could be relevant for later CVD.

Our findings are broadly in line with the narrative review behind the recently published American Heart Association (AHA) statement on menopausal transition and CVD [41]. In that review consistent with our findings, they do not find strong evidence that menopausal transition influences blood pressure or CIMT beyond chronological age and that there is evidence of an increase in fat mass through the menopausal transition, independent of chronological age, as well as fasting glucose, as we also find. They note that non-HDL-c increases across the menopause transition, which we also observed. Notably, they do not discuss in detail magnitudes of change and our review of key papers for this study suggest that these are modest (as in our study). They conclude that guidelines for CVD prevention should have specific reference to the menopause. They highlight the importance of early age at menopause as a risk factor for CVD and that those with surgical menopause, early menopause, and vasomotor symptoms should be considered for exogenous hormone replacement therapy. Previous cohort studies show that premature menopause is associated with CVD after adjustment for age and other CVD risk factors such as high blood pressure [38, 39]. The main aim of our paper adds to this work by using detailed repeat measures of established risk traits to show how these vary in relation to chronological and reproductive age. Whilst we show that chronological age seems to be more important for some risk factors, it is possible that the impact of reproductive age is influenced by those with premature menopause or early menopause. The previous studies were very large (N=144,000 and 301,000) to have power to compare risk of different cardiovascular diseases between premature menopause and menopause aged 5051 [39] or postmenopausal women without premature menopause [38]. Though the cited studies have much bigger sample sizes, we have repeat data and are able to separate the influence of both chronological and reproductive age. Furthermore, we did not find any evidence of non-linearity between reproductive or chronological age and many outcomes, suggesting that those with an earlier menopause did not appear to over influence our results. We do however note that it may not have been possible to pick this up in our sample. Furthermore, previous studies have found that changes in CVD risk factors over time were similar in women with natural and surgical menopause [34, 35], which supports our findings that chronological age might influence CVD risk more than reproductive age. In relation to the menopausal transition, they note that firm conclusions are difficult to make on the basis of current evidence but suggest supporting women to make behavioural changes (e.g. diet and physical activity) to maintain a healthy weight across mid-life would be potentially beneficial.

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Cardiovascular health in the menopause transition: a longitudinal study of up to 3892 women with up to four repeated measures of risk factors - BMC...

Easy-to-read medicine information about menopause hormonal therapy what it is, how to take it safely and possible side effects.

During menopause, the amount of oestrogen produced by a woman's body drops and this can cause symptoms associated with menopause such as hot flushes, night sweats, sleep problems, muscle and joint pains, mood changes, vaginal dryness and discomfort with sex. Read more aboutmenopause.

Menopause hormonal therapy (MHT) is the use of hormone therapy (tablets, patches or cream) to replace the oestrogen that your ovaries no longer make during and after menopause. It can help relieve some of the symptoms of menopause.

The main factor in deciding which MHT to use will depend of whether you still have a uterus or whetherit has been removed surgically (an operation called hysterectomy).

In addition, the choice of MHT will depend on your individual overall balance of benefit, risk, symptoms and convenience.

Image credit: MHT Australasian Menopause Society

Menopause hormonal therapy is not recommended in certain situations, such as for women who have a history of breast cancer, are at risk of heart disease, or have had a blood clot or are high risk of having a blood clot. Ask your doctor whether menopause hormonal therapy is right for you there are also other non-hormone options that can help with menopausal symptoms.

Menopause hormonal therapy is available as oestrogen alone or as oestrogen with progestogen. It is also available in different formulations such as creams, pessaries, tablets and skin patches. Some of these are used every day, while others may be used only for a few days or once or twice a week.

The following are examples ofmenopause hormonal therapy products available in New Zealand. The choice of product depends on your individual circumstances and preferences. When using MHT, use the lowest dose that eases your symptoms for the shortest time and get your treatment reviewed at least once every year to assess whether to continue it or not.

Read more about Ovestin cream and pessaries.

These patches are applied to your skin 1 or 2 times a week:

Without treatment, menopausal symptoms such as hot flushes, night sweats, sleep problems and headaches may last fora few years.Most women manage their menopause symptoms themselves, but some may need help from their doctor. MHT has been found to:

When assessing the risks associated with MHT, remember that not all women have the same risk of these effects.

For most women with moderate to severe symptoms, the benefits appear to outweigh the risks for those who are less than 10 years out from menopause or aged less than 60.

MHT can cause side effects such as breast tenderness, fluid retention, mood changes, menstrual spotting and bleeding. If you get any of these side effects, talk to your doctor as you may need a change of dose. MHT does not cause weight gain.

Contact your doctor immediately if you get any of the following symptoms while taking MHT:

If you are taking MHT and have recently had surgery or a leg injury and you are unable to walk around, contact your doctor for advice.

If you are taking MHT and decide to stop, ask your doctor how to stop safely. You may need to stop slowly over several weeks.

Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)?Report a side effect to a product

Many women consider using complementary therapies such as phytoestrogens. These oestrogen-like compounds are found in all plants but are in highest quantities in legumes, including beans and soy products. Some women find these compounds helpful, although scientific studies have found them no better than a placebo. A lack of response after 6 weeks should be seen as a reason to stop.

Similarly,scientific studies have also found the following to be no better than a placebo:black cohosh, dong quai, evening primrose oil, red clover and ginseng. Due to possible adverse effects on your liver, it is recommended that black cohosh treatment be ceased after 6 months.

All complementary therapies may have side effects and may interact with prescription medicines, so tell your doctor if you are using or planning to use these.

The following linkshave more information on MHT. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.Menopause Family Planning, New ZealandMenopause health information Australasian Menopause SocietyMenopause and HRT Patient Info, UKFacts about menopausal hormone therapyNational Institutes of Health, US

Medsafe Consumer Information Sheets:TrisequensKliogestKliovanceProgynovaEstradotClimaraPremarin

Hormone replacement therapyNZ FormularyMenopausal hormone therapy where are we now?BPAC, NZ, 2019Long term hormone therapy for perimenopausal and postmenopausal womenCochrane Database Syst Rev. 2012 Jul 11;7,Marjoribanks J, Farquhar C, Roberts H, et al.British menopause society & womens heath concern recommendations on hormone replacement therapyPanay N et al,May 2013

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Hormone replacement therapy (HRT) | Health Navigator NZ

For several decades, the role of hormone-replacement therapy (HRT) has been debated. Early observational data on HRT showed many benefits, including a reduction in coronary heart disease (CHD) and mortality. More recently, randomized trials, including the Women's Health Initiative (WHI), studying mostly women many years after the the onset of menopause, showed no such benefit and, indeed, an increased risk of CHD and breast cancer, which led to an abrupt decrease in the use of HRT. Subsequent reanalyzes of data from the WHI with age stratification, newer randomized and observational data and several meta-analyses now consistently show reductions in CHD and mortality when HRT is initiated soon after menopause. HRT also significantly decreases the incidence of various symptoms of menopause and the risk of osteoporotic fractures, and improves quality of life. In younger healthy women (aged 50-60 years), the risk-benefit balance is positive for using HRT, with risks considered rare. As no validated primary prevention strategies are available for younger women (<60 years of age), other than lifestyle management, some consideration might be given to HRT as a prevention strategy as treatment can reduce CHD and all-cause mortality. Although HRT should be primarily oestrogen-based, no particular HRT regimen can be advocated.

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Hormone-replacement therapy: current thinking - PubMed

Women with lower levels of two sex hormones may be at increased risk of experiencing obstructive sleep apnea (OSA) in middle age, according to a new study.

The findings, published June 22 in PLOS ONE, showed that postmenopausal women with double the average estrogen concentration had as much as a 23% decrease in the odds of snoring. Women with double the average progesterone concentration had a 9% decrease in the odds of snoring.

"Our study is important, as it is another building block on the way to individualized hormone substitution for postmenopausal women," said Kai Triebner, PhD, postdoctoral fellow at the University of Bergen, Norway, and senior author of the article. "The observed associations had already been suspected by smaller studies, and now we finally were able to prove them in a large population-based cohort with very precise measurements of their hormone status."

OSA is marked by snoring, irregular breathing, and/or gasping. The condition can lead to poor sleep quality and is associated with an increased risk of cardiovascular conditions, including ischemic heart disease and stroke.

Previous studies have shown that estrogen and progesterone mitigate the symptoms of OSA. Triebner and his colleagues sought to evaluate the protective association between hormones and sleep on a population level.

The new study included 774 women (age, 4067 years) from the 20102012 European Community Respiratory Health Survey. The women responded to two questionnaires about respiratory health and sleep and gave blood for hormone analysis of progesterone and three types of estrogen: 17-estradiol, estrone, and estrone 3-sulfate.

Women with hormonal irregularities, such as endometriosis, and those taking exogenous sex hormones through replacement therapy or contraception were excluded from the study.

Among the total group, 551 reported snoring. Of those, 411 had additional symptoms of OSA, such as irregular breathing, gasping, or a disturbing snore. Triebner and his colleagues determined the average estrogen and progesterone concentrations of all women in the study. Women with double the average estrogen concentration had a 19% decrease in odds of snoring.

With regard to individual forms of estrogen, women with double the average serum concentration of 17-estradiol, estrone, and estrone 3-sulfate had a 17% to 23% decrease in odds of breathing irregularity. Women with double the average serum concentration of progesterone had a 9% decrease in the odds of snoring and a 12% decrease in the odds of waking up with a choking or gasping sensation.

"By adjusting our model for BMI [body mass index] and alcohol consumption, we found that the results of the study [the effect of hormones on the risk of OSA] were not influenced," Triebner told Medscape Medical News.

Triebner's team did not give women exogenous estrogen or progesterone to observe individual changes in sleep behavior.

"The path to a good hormone replacement therapy is not yet paved," Triebner said. "What may be beneficial for one woman might be actually harmful to the other. The next steps are considerably more research on how to properly administer an individualized hormone therapy to women."

Vincent Joseph, PhD, a sleep researcher at Laval University, Quebec, Canada, said the findings were unsurprising.

"The mechanisms have been addressed, at least partially, in animal studies, showing effects on key structures in the brain and elements of the peripheral nervous system that are involved in the control of respiration," Joseph, who was not involved in the study, told Medscape.

However, the results provide a much stronger case to support the link between the variation of hormone levels and sleep apnea in women, Joseph added.

Triebner and Joseph reported no relevant financial relationships.

PLoS One. Published online June 22, 2022. Full text

Arianna Sarjoo is an intern at Medscape and a biology major at Boston University.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

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Lower Hormone Levels Linked to Risk of Sleep Apnea - Medscape

Pune, India, June 29, 2022 (GLOBE NEWSWIRE) -- The global hormone replacement therapy market size was USD 13.40 billion in 2020. The market is projected to grow from USD 14.17 billion in 2021 to USD 21.49 billion in 2028 at a CAGR of 6.1% in the 2021-2028 period. This information is provided by Fortune Business Insights, in its report titled, Hormone Replacement Therapy Market, 2021-2028."According to our expert analysts, the market is witnessing growth, owing to its development in several other hormone-associated illnesses concerned with diverse age groups that are impacting both, women as well as men.

Industry Developments:May 2021: Myovant Sciences GmbH declared that it gained sanction from the U.S. FDA for hormone therapy Myfembree as a treatment for uterine fibroid bleeding. The drug unveiled by Myovant is set to give uninterrupted competition to Abbvie with an extra dosing benefit.

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Unveiling of Radical Drug Delivery Systems with Spurred Efficiency to Drive Market Growth

Hormone replacement therapy is vital for patients with growth hormone scarcities, women experiencing menopausal conditions, elderly population having hypogonadism, and other patients. The treatment is obtainable in several forms, which involve skin and buccal patches, injectable, and tablets, and others. Attributed to the increase in implementation of these products across the world, numerous manufacturers are emphasizing on the development of the progressive drug delivery systems such as vaginal estrogen drugs as well as transdermal estrogen patches. This is expected to bolster the hormone replacement therapy market growth.

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A hormone replacement therapy is a treatment to replace the natural hormone when the body does not produce enough hormone. The hormonal replacement therapy is generally used to treat the menopause symptoms and to protect long term health. During the menopause, the female hormone level goes up and down. This can cause various symptoms, such as night sweat and vaginal dryness.

Thus, hormone replacement therapy helps to balance the level hormone among the females. In addition to this, hormone replacement therapy also helps in the prevention of cardiovascular diseases and osteoporosis after menopause in females. In addition to this, the hormone replacement therapy also reduces the chance of various diseases, including diabetes and bowel cancer. In male hormone replacement therapy, testosterone hormone is given to the man. Testosterone hormone is responsible for the development of male sex organs and producing male characteristics such as muscularity and facial hairs.

Hormone replacement therapy is generally used to balance the level of progesterone and estrogen hormone in females. Currently, the combination of drugs is used for hormone replacement therapy. The hormone replacement therapy can be given to various forms, including oral, parenteral, and transdermal. Oral intake of hormone drug is one of the most common routes of administration in the hormone replacement therapy.

Hormone therapy, including estrogen therapy and combined estrogen/progesterone therapy, has been currently approved by the Food and Drug Administration (FDA) for the treatment of osteoporosis among the females. There are many companies present in the market who are offering a variety of medicines for the hormone replacement therapy for both male and females.

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Therapy Type, Indication, Route of Administration, Distribution Channel, and Region are studied for the Market

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The report offers a holistic evaluation of the hormone replacement therapy market along with present trends and forthcoming expectations to launch approximate investment profits. Moreover, a detailed examination of any forthcoming opportunities, threats, competitions or driving aspects is also conversed in the report. Step by step, methodical regional review is offered in the report.COVID-19 influences have been added to the report to aid investors and business owners to perceive an amplified knowledge of the existing threats. The key players in the market are distinguished, and their tactics to bolster the market growth are mentioned in the report.

Regional Insights:The market in North America was worth USD 7.07 billion in 2020 and held the maximum hormone replacement therapy market share. Moreover, the market is anticipated to lead the global market, owing to an increase in the occurrence of menopause and growth hormone scarcity illnesses.Europe is the second dominant region, owing to an escalation in the hormonal conditions in women experiencing menopausal symptoms, older people undergoing hypothyroidism, and increase in growth hormone ailments.Asia Pacific is projected to appear as one of the biggest suppliers of the product coupled with the highest CAGR in future.

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With 6.1 % CAGR, Hormone Replacement Therapy Market Size worth USD 21.49 billion by 2028 Industry Trends - Benzinga

Hot flashes, sleep difficulties, and mood changes are just a few of the common symptoms associated with menopause. But fluctuating hormone levels can also impact some unexpected parts of your body, like your mouth. As your estrogen levels decrease during perimenopause and menopause, you may notice sensitive teeth, painful gums, and other issues.

Some people notice that things taste different during the menopausal transition. You may even develop something called burning mouth syndrome, which is just as unpleasant as it sounds.

Keep reading to learn about the ways menopause may be affecting your mouth and what you can do to find relief.

Regular brushing and flossing, avoiding excess sugar, and getting regular dental cleanings are all ways you can actively protect your oral health. But some things, like hormonal fluctuations, are outside of your control.

In fact, hormonal changes can affect your teeth during several stages of your life. This may happen in the following ways:

A decrease in hormones during perimenopause and menopause can cause a variety of mouth-related changes. This may result in the following symptoms:

If you regularly experience pain after drinking or eating hot or cold items, you could have tooth sensitivity.

Sensitive teeth develop when the dentin, or inner part of the teeth, lose both their protective enamel and cementum coatings. This leaves the nerves within your teeth vulnerable, which can lead to pain and discomfort when you consume cold, hot, or acidic foods.

Menopausal gingivostomatitis is a menopause-related oral health condition that causes gum inflammation. In addition to gum swelling, you may have noticeably pale, shiny, or deep-red gums. Your gums may also bleed easily, especially when you brush or floss.

Hormonal changes during the menopausal transition can also change the way foods taste to you. For example, you may find yourself bothered by salty, sour, or peppery foods. Its also possible for food to taste unusually bitter or metallic.

In some cases, menopause-induced taste changes accompany a condition known as burning mouth syndrome (BMS). As the name suggests, BMS causes burning, pain, and tenderness around your mouth area, including the lips, tongue, and cheeks.

Tooth pain during menopause is related to both hormonal and age-related causes, such as thinning mouth tissues, dry mouth, and osteoporosis.

As estrogen levels decrease, the oral mucosal epithelium may also decrease in thickness. This can make you more sensitive to pain, as well as more vulnerable to infections in your mouth.

Salivary glands are partially dependent on hormones to continue supporting saliva production and maintain consistency.

Lower levels of estrogen can also decrease saliva production in your mouth, causing a condition known as dry mouth. Not only can dry mouth make it uncomfortable to swallow foods and liquids, but it may also contribute to tooth decay when left untreated.

Other problems associated with dry mouth include:

Postmenopausal people are at an increased risk of osteoporosis due to declining estrogen levels. This condition weakens bones, which can cause them to break easily.

While you might associate this age-related condition with thinning bones throughout your body, its important not to forget about the bones inside the mouth. In particular, osteoporosis may cause jaw recession, which can decrease the size of your gums and lead to tooth loss.

If youre experiencing menopause-related tooth changes that are significant and interfering with your overall quality of life, its important to reach out to a dentist or doctor to see if treatment can help.

Hormone replacement therapy (HRT) is one possible option that may help alleviate multiple menopausal symptoms. However, not everyone is a good candidate for HRT due to the possibility of serious side effects, such as blood clots.

Still, some research does demonstrate the benefits of HRT for postmenopausal oral health issues. One study of 492 postmenopausal people, compared those who received osteoporosis treatments, such as HRT or supplements, to those who received no treatment.

Researchers found that those who received estrogen treatments for osteoporosis prevention also had a significantly lower risk of developing periodontitis, a severe infection of the gums that may also damage your teeth and jawbone.

However, as previous research points out, theres not enough clinical evidence to establish whether HRT is an effective preventive measure for oral health problems following menopause.

If youre interested in HRT, its important to carefully discuss the risks versus benefits with a doctor.

While hormonal changes can lead to changes in your mouth, problems with your teeth and gums arent inevitable.

Its important to see a dentist if youre experiencing any unusual changes in your oral health, such as dry mouth, tooth sensitivity, or pain. They may recommend corrective procedures or medications that can help address these issues.

Additionally, your dentist might recommend the following:

Also, certain lifestyle modifications may help you maintain healthy teeth and gums, such as quitting smoking and cutting back on sugary foods and beverages. If you have dry mouth, reducing caffeine and alcohol consumption may also help.

Hormone fluctuations especially a drop in estrogen can cause a variety of uncomfortable symptoms. While these can impact your mood, sleep quality, and body temperature, menopause may also lead to changes in your mouth.

While some menopause-related oral health changes may cause slight discomfort, others, such as dry mouth, can lead to bigger issues with your teeth and gums.

Protecting your oral health during menopause can lead to better outcomes for gums and teeth as you age, as well as better overall quality of life. If lifestyle modifications and regular oral care dont help alleviate your symptoms, see a dentist or doctor for possible prescription treatments.

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Menopause and Sensitive Teeth: Symptoms, Causes, Treatments - Healthline