For most of human history, women combated symptoms of menopause with natural treatments, many of them still used to this day with varying success. Herbal remedies and alternative treatments, such as black cohosh, acupuncture or even cannabis, are still used today to alleviate the unpleasant symptoms, although evidence of their effectiveness is scarce. Medical science began rapid advancement in the 1800s, leading to the development of the truly effective and scientifically proven treatments we know and use today.
Menopause is a natural part of a woman’s life, but that does not mean you have to suffer the symptoms and do nothing about them. Any discomfort should be alleviated in order to live stress-free and stay able to concentrate on the pleasant and exciting side of your professional and family life. One of the most effective ways to combat menopause symptoms is hormone replacement therapy, or HRT.
Beginnings of HRT
For over six decades, menopausal women have been treated with HRT in order to keep them young and retain their femininity. The first tablet-based drug was launched in the mid-1940s in the US. This estrogen supplement was created using so-called conjugated estrogens (CEE), obtained from horses. After a decade, a more advanced and risk-free HRT medicine was created, which contained a synthetic progestin as well.
Wonder drug
By the 1960s, it had been determined through appropriate research that estrogen could be used to effectively combat hot flashes. Hormone replacement therapy was celebrated as a true fountain of youth, promising eternal beauty, long life and perpetual lust – all of which were merely exaggerated claims of course. Sadly, later on in the 1970s there was an increased incidence of uterine cancer due to estrogen use. As a result, doctors and patients became insecure about the “miracle treatment”, and hormone therapy was discredited.
Overexcitement and overuse
Luckily, medical science found a solution to this problem. It was found that the corpus luteum hormone progesterone is an opponent to estrogen, the hormone causing health risks when used by itself. Hormone therapy until then had been treated like an anti-ageing treatment that protects users from osteoporosis, Alzheimer’s disease, heart attack, stroke, and more. Hormone doses and the duration of therapy were limitless, and hormone therapy continued to be used that way until the 90s.
A misleading study
But then came the Women's Health Initiative study in 2002, which represents the biggest setback for hormone replacement therapy in its history. It did not confirm the protective effects of hormones against various diseases in menopausal women. On the contrary, the study found that women treated with estrogens and progestins, in contrast to those who had received a placebo, had more heart attacks or thrombosis, and were more likely to develop breast cancer. Although its results and statistical analyses have been widely questioned and criticized, the damage was done: the public was shocked. To date, hardly any medical therapy has been so medially torn and vilified every day as hormone replacement therapy – a process that still affects some women today. Their concerns should be addressed and eliminated in a detailed conversation with a doctor.
Careful with the alternatives
In the search for alternatives to conventional hormone replacement therapy, many women come across so-called nature-identical or bioidentical hormones - freely available on the Internet or mixed according to the recipe in the pharmacy. It is claimed that these “natural” hormones should be better tolerated than the "synthetic" hormones of the pharmaceutical industry.
It does not matter for the effect in the body whether the hormones are chemically synthesized or naturally produced by the body. However, the dose and the mode of intake of the added hormones are very relevant, as is the quality of the product. Use only products that have been approved by the relevant authorities, from companies who make their products according to well-established international standards, with accountable quality assurance!
Do not self-medicate
There are a few other groups of drugs that are used in menopausal conditions, especially antidepressants. Using depression medication to combat the symptoms of menopause is considered “off-label use” – this means that the drugs are not approved for this treatment, therefore, the benefit to risk ratio of their use for menopausal symptoms has not been established. In addition, there may be possible side effects or interactions with other drugs. Importantly, the effectiveness of antidepressants cannot compare to HRT, but its exact method and dosage should be determined by a doctor in every case.
Safe if supervised
Today, HRT is widely recommended by medical professionals worldwide: according to the International Menopause Society hormone treatment in menopause remains the most effective method to treat vasomotor symptoms and urogenital atrophy, and controlled doses (lower than before the 2002 study came out) may sufficiently reduce the symptoms of menopause and maintain the quality of many women's lives. Healthy women under 60 should not worry about the safety of using HRT.