Monday, March 12, 2012

Understanding the Role of Estrogen: What is Menopause?

Medivision presents an excerpt from our 90 minute medical education video Obstetrics and Gynecology: Understanding the Role of Estrogen, featuring Matan Yemini, MD. on the topic of "What is Menopause?". The full length film, along with many other medical education titles, is available on VHS or DVD from and covers the following topics: Comprehensive Health Care to the Peri-Menopause, Current Research Trends, Hormone Replacement Therapy and Nursing Perspectives in Menopause Management.

Hormone replacement therapy was recently considered to be a standard treatment for women with hot flashes and other menopause symptoms, and was also thought to have the long-term benefits of preventing heart disease and possibly dementia. However the use of hormone therapy changed abruptly when a large clinical trial found that one type of hormone therapy actually posed more health risks than benefits, particularly when given to older postmenopausal women. As the concern about health hazards attributed to hormone therapy grew doctors became less likely to prescribe it, and it is no longer recommended for s heart disease or memory loss.

However, further review of clinical trials and new evidence show that hormone therapy may still be a good choice for certain women, depending on their risk factors and on whether they take systemic hormone therapy or low-dose vaginal preparations of estrogen. For women who experience menopause naturally, estrogen is typically prescribed along with progesterone or progestin because estrogen alone can stimulate growth of the lining of the uterus, increasing the risk of uterine cancer.

Despite the health risks, systemic estrogen is still the most effective treatment for menopausal symptoms. The benefits of hormone therapy may outweigh the risks if you're healthy and:
  • Experience moderate to severe hot flashes or other menopausal symptoms
  • Have lost bone mass and either can't tolerate or aren't benefitting from other treatments
  • Stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40 (premature ovarian insufficiency)
Women who experience an early menopause, particularly those who had their ovaries removed and don't take estrogen therapy until at least age 45, have a higher risk of:
  • Osteoporosis
  • Coronary heart disease (CHD)
  • Earlier death
  • Parkinsonism (Parkinson's-like symptoms)
  • Dementia
  • Anxiety or depression
  • Sexual function concerns
Early menopause typically lowers the risk of most types of breast cancer and ovarian cancer. For women who reach menopause prematurely, protective benefits of hormone therapy usually outweigh the risks.

To determine if hormone therapy is a good treatment option for you, talk to your doctor about your individual symptoms and health risks. As researchers learn more about hormone therapy and other menopausal treatments, recommendations may change. If you continue to have bothersome menopausal symptoms, review treatment options with your doctor on a regular basis.

 Further Reading:
Hormone therapy: Is it right for you? -