AI-generated“You still have your period, so you do not need hormones.” As a blanket statement, this does not do justice to women with troubling symptoms. Treatment can be discussed before the last menstrual period.
Symptoms and your personal situation are decisive
Whether menopausal hormone therapy, or HRT, is suitable depends on symptoms, their severity, possible contraindications and your preferences. Continuing periods do not exclude a treatment discussion. However, they do not automatically lead to an HRT recommendation either.
What do oestrogen and progesterone do?
Systemic oestrogen is used for troublesome hot flushes and night sweats. If the womb is present, its lining generally also needs adequate progestogen protection. Micronised progesterone is one possible form of this protection. The suitable regimen depends on bleeding patterns, oestrogen dose and medical history, among other factors.
This protective function is distinct from the imprecise self-diagnosis of “progesterone deficiency”. Treatment is not justified solely by a symptom quiz result.
Tablet, patch, gel or spray?
The route of administration can matter when weighing risks. With increased thrombosis risk, transdermal application is often considered. This does not mean every preparation is safe for every woman. Previous thrombosis or other relevant conditions require individual advice, sometimes from a specialist.
How should breast cancer risk be understood?
“HRT always causes breast cancer” is as inaccurate as “bioidentical means risk-free”. Risks and benefits differ with treatment type, duration and personal baseline risk. Study figures should only be explained with their timeframe, the treatment studied and comparison group. A single number cannot apply to every woman.
What about contraception?
Conventional HRT is not contraception. Pregnancy may still be possible during perimenopause. Contraception and treatment therefore need to be planned together. Do not stop or combine existing preparations yourself based on an internet article.
Are there alternatives?
Depending on the main symptom, non-hormonal treatments may also be suitable. Menopause-specific cognitive behavioural therapy, for example, can help with managing troubling symptoms. Depression, a sleep disorder or another condition may need its own treatment.
What happens after starting?
The effect, tolerability and bleeding pattern are discussed over time. The practice's planned HER treatment pathway includes a follow-up after six to eight weeks. Further checks depend on treatment and individual circumstances. Unexplained bleeding should be assessed before starting, or when it newly occurs.
Bring your medicine list, main symptoms and previous findings. You do not need to know beforehand which hormone or preparation might suit you.
Discuss your symptoms at your own pace
Would you like a medical assessment of your changes? At Praxis Jona in Berlin-Mitte, we discuss your questions and suitable next steps.
Enquire about menopause advice
Read more
- Oestrogen dominance or progesterone deficiency: what is behind these terms?
- Vaginal dryness and urinary symptoms during menopause
- Perimenopause at 35 or 40: am I too young?
