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The Benefits of Menopausal Hormone Therapy for Treating Vasomotor Symptoms

In This Article

  • For healthy women under age 60 or within ten years of menopause who have bothersome vasomotor symptoms, studies have shown that the benefits of menopausal hormone therapy typically outweigh the risks
  • While there are some cardiovascular risks associated with hormone therapy, low dose, transdermal estrogen formulations are likely safer for women with risk factors
  • Women experiencing bothersome menopausal symptoms should consult their health care providers about hormone therapy

Hot flashes and night sweats affect approximately 70% of midlife women, and for many, these symptoms can persist for a decade or longer. For women experiencing bothersome vasomotor symptoms, menopausal hormone therapy with estrogen and progestogen is a highly effective treatment that can significantly improve quality of life.

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Jan Shifren, MD, director of the Massachusetts General Hospital Midlife Women's Health Center, discusses menopausal hormone therapy in an episode of the JAMA Clinical Reviews podcast.

While a wide range of doses and formulations of menopausal hormone therapy are available, women should use the lowest effective dose to treat their symptoms. Dr. Shifren notes that it is important to individualize care, and both clinicians and patients should understand that it may take up to three months to achieve maximum benefit. Length of treatment should also be determined on an individual basis by the woman and her health care provider.

Although hormone therapy is highly effective, it is not without risks. Adverse effects include a slight increase in the risk for breast cancer, heart disease, venous thromboembolic events and stroke, though use of transdermal (rather than oral therapies) may mitigate some of these risks.

For Dr. Shifren, the most important takeaway is this: for healthy women under age 60 or within ten years of the onset of menopause with bothersome vasomotor symptoms, the benefits of menopausal hormone therapy will typically outweigh the risks.

She recommends that women experiencing disruptive hot flashes or night sweats consult their clinicians about the option of hormone therapy and decide together whether the benefits will outweigh potential risks.

70%
of midlife women are affected by bothersome vasomotor symptoms, including hot flashes and night sweats

Learn more about the Midlife Women's Health Center

Refer a patient to the Department of Obstetrics and Gynecology

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