Contraceptive Patch (Ortho Evra) What is it? The patch is a prescription-only, reversible, contraceptive method worn on a woman’s skin that releases estrogen and progestin into the woman’s bloodstream. What are the Best Tips for Stopping Hormone. When taken in the patch form, patients should cut the patch in half and use only.
Hormones and Menopause . Talk with your doctor about the risks and benefits of menopausal hormone therapy.
STOPPING ESTROGEN TREATMENT (Sometimes called “HRT”) Dr. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research In July 2002 the largest randomized placebo-controlled study of “Hormone. Stopping Hormone Replacement Therapy (HRT). We here at the Women's Menopause Health Center refuse to take away your choice of a healthy alternative to Premarin.
Waking up flushed and sweaty several times a night left Cathy feeling tired all day. But when she began to feel hot on and off during the day as well, she went to see Dr. He told Cathy she was having hot flashes—a sign that she was starting the menopause transition. Kent talked about several ways to control her hot flashes. One was to use the hormone estrogen for a short time. He talked about the benefits and risks of this choice.
It has been 5 months since I cut my estradiol patch in half; the next step in getting off HRT (Hormone Replacement Therapy.) Thankfully, the process has been relatively easy. Oh sure, I’ve had hot flashes on occasion. The patch looks like a square Band-Aid (less than 2. It contains hormone medicine similar to birth control pills, but the dose absorbed through the skin is 60% higher than the birth control. Like any medication, the hormones used in hormone replacement therapy (HRT) can sometimes have side effects. Any side effects usually improve over time, so it's a good idea to persevere with treatment for at least three months. Here we assess Hormone Replacement Therapy (including Risks and Benefits). What exactly are the risks of Hormone Replacement Therapy and the benefits of Hormone Replacement Therapy. Learn about CombiPatch, a hormone therapy that combines estrogen and progestin in a twice-weekly patch. Many women find hormone replacement therapy helps reduce menopausal symptoms. Read our information about it including side-effects and possible risks.
Cathy said she remembered hearing something on a TV talk show about using hormones around menopause. She didn’t know. A hormone is a chemical substance made by an organ like the thyroid gland or ovary. Hormones control different body functions. Examples of hormones are estrogen, progesterone, testosterone, and thyroid hormone. In a woman’s body during the menopause transition, the months or years right before menopause (her final menstrual period), levels of several hormones, including estrogen and progesterone, go up and down irregularly. This happens as the ovaries begin working less and less well.
Menopause is a normal part of aging. It is not a disease or disorder.
Women who have symptoms like hot flashes and night sweats may decide to use hormones like estrogen because of the benefits, but there are also side effects and risks to consider. Dr. Kent told Cathy to call back for a prescription if she decided to try using hormones to relieve her symptoms. She read pamphlets from the doctor’s office and talked to her friends.
Lily, who had surgery to remove her uterus and ovaries, has been taking the hormone estrogen since the operation. Sandy said she’s had a few hot flashes, but isn’t really uncomfortable enough to take hormones. Melissa is bothered by hot flashes and can’t sleep, but her doctor thinks she should not use estrogen because her younger sister has breast cancer.
Each friend had a different story. Cathy wanted more information. What about hormones? Symptoms such as hot flashes might result from the changing hormone levels during the menopause transition. After a woman’s last menstrual period, when her ovaries make much less estrogen and progesterone, some symptoms of menopause might disappear, but others may continue or get worse. To help relieve these symptoms, some women use hormones.
This is called menopausal hormone therapy (MHT). This approach used to be called hormone replacement therapy or HRT. MHT is a more current, umbrella term that describes several different hormone combinations available in a variety of forms and doses.
This tip sheet does not talk about non- hormone options for menopause symptoms. Ask your healthcare provider for more information about these treatment options. How would I use menopausal hormone therapy?
Estrogen is a hormone used to relieve the symptoms of menopause. A woman whose uterus has been removed can use estrogen only (E). But a woman who still has a uterus must add progesterone or a progestin (synthetic progesterone) along with the estrogen (E+P). This combination lowers the chance of an unwanted thickening of the lining of the uterus and reduces the risk of cancer of the uterus, an uncommon, but possible result of using estrogen alone. Cathy’s friend Stephanie takes a pill containing estrogen and progestin, but Cathy has trouble swallowing pills.
If MHT is only available as a pill, that is something she’d consider when making her decision. Estrogen comes in many forms. Cathy could use a skin patch, vaginal tablet, or cream; take a pill; or get an implant, shot, or vaginal ring insert. She could even apply a gel or spray.
There are also different types of estrogen (such as estradiol and conjugated estrogens). Estradiol is the most important type of estrogen in a woman’s body before menopause. Other hormones, progesterone or progestin, can be taken as a pill, sometimes in the same pill as the estrogen, as well as a patch (combined with estrogen), shot, IUD (intrauterine device), gel, or vaginal suppository. The form of MHT your doctor suggests may depend on your symptoms. For example, an estrogen patch (also called transdermal estrogen) or pill (oral estrogen) can relieve hot flashes, night sweats (hot flashes that bother you at night), and vaginal dryness.
Other forms—vaginal creams, tablets, or rings—are used mostly for vaginal dryness alone. The vaginal ring insert might also help some urinary tract symptoms. The dose can also vary, as can the timing of those doses. Some doctors suggest that estrogen be used every day, but that the progesterone or progestin be used cyclically—for 1. A cyclic schedule is thought to mimic how the body makes estrogen and progesterone before menopause. This approach can cause some spotting or bleeding, like a light period, which might get lighter or go away in time. Alternatively, some women take estrogen and progesterone or progestin continuously—every day of the month.
Is there a downside to taking hormones? A lot of the information Cathy read said that taking estrogen is the most effective way to relieve hot flashes, night sweats, and vaginal dryness. Estrogen also helps keep bones strong. Cathy thought that those seemed like good reasons to use MHT. But she wondered, is there a downside? Research has found that, for some women, there are serious risks, including an increased chance of heart disease, stroke, blood clots, and breast cancer, when using MHT. The Women’s Health Initiative (see below) also found an increased risk of possible dementia in women who started MHT after age 6.
These concerns are why every woman needs to think a lot before deciding to use menopausal hormone therapy. Also, some women develop noticeable side effects from using hormones.
Breast tenderness. Spotting or a return of monthly periods. Bloating. By changing the type or amount of the hormones, the way they are taken, or the timing of the doses, your doctor may be able to help control these side effects. Or, over time, they may go away on their own. What more should I know about the benefits and risks of hormones? Cathy knows there have been news stories about menopausal hormone therapy research findings.
But, several years ago, when she first heard about the risks of using estrogen, she didn’t really pay attention. Now she wants to know more about the risks. Over the years, research findings have led to a variety of positive, negative, and sometimes conflicting reports about menopausal hormone therapy. Some of these findings came from randomized clinical trials, the most convincing type of research. Historically, clinical trials often used one type of estrogen called conjugated estrogens. Several other types of estrogen, as well as progesterone and progestins, have also been tested in small trials to see if they have an effect on heart disease, breast cancer, or dementia. Let’s look more closely at what we have learned from these small studies.
Hot flashes and night sweats. Estrogen will relieve most women’s hot flashes and night sweats. If you stop using estrogen, you may again start having hot flashes. Lifestyle changes and certain prescription medicines also might help some women with hot flashes. For most women, hot flashes and night sweats go away in time.
Vaginal dryness. Estrogen improves vaginal dryness, probably for as long as you continue to use it. If vaginal dryness is your only symptom, your doctor might prescribe a vaginal estrogen. A water- based lubricant, but not petroleum jelly, may also relieve vaginal discomfort. Cholesterol levels. Estrogen improves cholesterol levels, lowering LDLs (the “bad” kind of cholesterol) and raising HDLs (the “good” kind of cholesterol).
The pill form of estrogen can cause the level of triglycerides (a type of fat in the blood) to go up. The estrogen patch does not seem to have this effect, but it also does not improve cholesterol to the same degree as the pill form. But, improving cholesterol levels is not a reason to take estrogen. Other medicines and lifestyle changes will improve cholesterol levels more effectively. What is the Women’s Health Initiative? What have we learned from it? Before menopause, women generally have a lower risk of heart disease than men.
This led experts to wonder whether giving women estrogen after menopause might help prevent heart disease. In 1. 99. 2, the National Institutes of Health (NIH), the nation’s premier medical research agency, began the Women’s Health Initiative (WHI) to explore ways postmenopausal women might prevent heart disease, as well as osteoporosis and cancer. One part of the WHI, the Hormone Trial, looked at oral conjugated estrogens used alone (E therapy or ET) or with a particular progestin (EPT) to see if, in postmenopausal women, estrogen could prevent heart disease without increasing the chance of breast cancer. In July 2. 00. 2, the EPT part of the WHI Hormone Trial was stopped early because it became clear to the researchers that the overall risk of taking E+P outweighed the benefits: Benefits. Fewer fractures. Less chance of cancer in the colon and/or rectum. Risks. More serious blood clots. More heart attacks.
More breast cancers. In April 2. 00. 4, the rest of the Hormone Trial, the E alone or ET trial, was also halted because using estrogen alone increased the risk of stroke, and it was not likely that there would be a positive effect on heart attacks. Unlike using estrogen plus progestin, using estrogen alone did not increase the risk of heart attacks or breast cancer, but like the EPT trial, there were fewer fractures.
During the first 3 years after stopping the WHI EPT trial, women were no longer at greater risk of heart disease, stroke, or serious blood clots than women who had not used MHT. On the other hand, they also no longer had greater protection from fractures.
The women still had an increased risk of breast cancer, but their risk was smaller than it was while they were using hormones.