Perimenopause is the time to start reflecting on how your hormones are behaving. Many ladies ask me ‘when should I start thinking about HRT?’ If you are over 45 years of age then it is not unusual to have started noticing new symptoms related to your periods, mood, sleep, libido, night sweats, hot flushes, urinary symptoms or vaginal dryness. The most likely cause is a change in your hormonal balance. If you are experiencing symptoms, then this is the time to explore your options and have a discussion with your doctor or a menopause expert. HRT will help alleviate almost all of these new symptoms.
In the majority of women, blood tests are not necessary to commence HRT treatment. In some circumstances, however, if there is doubt about a diagnosis or poor response to treatment, then blood tests can be done by a specialist.
On the other hand, if you are not experiencing any distressing symptoms and are nearing the average age of menopause, which is 51, you can still have a discussion with your doctor about your options and the elective choice to go on HRT for its many benefits for future overall health. These include: maintaining your bone health, reducing the risk of heart attack and stroke, preventing painful sex and bladder problems, to name but a few. If prescribed appropriately HRT does not carry any increased risks. Absolute contraindications to treatment are rare; receptor positive breast cancer being the most important one.
Studies indicate that hormone therapy when commenced before 59 years of age will give all the parameters, especially those related to the preservation of bone density and reducing heart disease risk, the best chance. It does not mean that hormone balance therapy after this age will not carry benefits, but the impact will not be as significant as when started earlier.
When weighing up the benefits versus risks of hormone balance therapy it is important to remember that there is more robust evidence for the benefits compared to the small increase in potential risks. Although the increase in the risk of breast cancer is very small it is further reduced by appropriate prescribing.
The post-reproductive health of women, that is, our life after finishing our periods, is very important. This is our second innings and we will be playing this game until we die! So, it is extremely important not only to reflect on our lifestyle choices, but equally, to consider our hormone balance for its benefits to our well-being. Men, by nature of things, do not see a decline in testosterone levels until their seventies. The health benefit of their hormones has at least a 20-year advantage over ours.
A myriad of life experience awaits us after menopause and we would like to be as fit, well and physically independent as possible to enjoy everything.
Think perimenopause, menopause – think my choices, my hormone balance.