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postmenopausal hormone replacement - to use or not to use

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The aging process is beautiful.  We are wiser, at least some of us are.  Some of us suffer from the aging process more severely with dreadful menopausal symptoms such as hot flashes, mood changes, night sweats, and insomnia.  HRT (hormone replacement therapy with estrogen with progestin to protect against uterine cancer)  can reduce menopausal symptoms.  Some women can suffer for up to 10 years with night sweats and hot flashes.  Because of the repeated recommendation against HRT's chronic condition prevention, some women and doctors hesitate to use HRT to treat these unbearable symptoms.  SSRI, gabapentin, and clonidine have been used to treat menopausal symptoms in order to avoid using HRT.  But these drugs lack long-term studies compared to HRT to treat postmenopausal symptoms and no drug is without side effects. (JAMA Nov1 2022 vol 328 no17 pg 1712)  

My team will discuss the HRT options with you if you are going through menopause symptoms.  If you have been on HRT, believing that it will delay aging, or prevent chronic illness including dementia--  there is much research against it.  We can help you wean off HRT if you do not have any more menopausal symptoms.  


SHAWN HAMILTON, MD, MBA Internal medicine physician with 20 year of experience as PCP.

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