Hormone Therapy for Menopause and Perimenopause
Plan ahead: Expect some rebound and be prepared with alternatives to handle annoying symptoms — lubricants for vaginal dryness, for example, or dressing in sheddable layers to cope with hot flashes.
Time it right: Sometimes menopause hits when women feel they cannot deal with one more problem in their lives, says Dr. Gass. But later, life may settle down, making even bothersome symptoms more manageable. Just don’t try to stop in summer, when hot flashes are harder to deal with, advises Dr. Richardson.
Taper off: Experts really aren’t sure whether this is better than quitting cold turkey, but many doctors suggest a step-down plan: taking a lower dose or skipping pills every other day. Dr. Richardson believes that tapering off helps, but it should be done very slowly, and a woman should stay at any given level for at least three months. If you get to the point where symptoms start to crank up slightly, stay at that level for up to a year, then try lowering some more. In any case, don’t try these approaches on your own; work with your doctor.
Some women quit hormones more than once — “five times and counting,” says Kalell — and some stay on for years, having decided that it’s reasonably safe for them. It’s critical to report unusual symptoms, especially unexpected bleeding or spotting, a possible warning sign of cancer, and to be scrupulous about mammograms. It’s also important to keep revisiting the question of risk and benefit, especially as you get older and your health issues change.
Originally published on March 27, 2008
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Hormone Therapy for Menopause and Perimenopause
When (and How) to Get Off HT continued...
Plan ahead: Expect some rebound and be prepared with alternatives to handle annoying symptoms — lubricants for vaginal dryness, for example, or dressing in sheddable layers to cope with hot flashes.
Time it right: Sometimes menopause hits when women feel they cannot deal with one more problem in their lives, says Dr. Gass. But later, life may settle down, making even bothersome symptoms more manageable. Just don’t try to stop in summer, when hot flashes are harder to deal with, advises Dr. Richardson.
Taper off: Experts really aren’t sure whether this is better than quitting cold turkey, but many doctors suggest a step-down plan: taking a lower dose or skipping pills every other day. Dr. Richardson believes that tapering off helps, but it should be done very slowly, and a woman should stay at any given level for at least three months. If you get to the point where symptoms start to crank up slightly, stay at that level for up to a year, then try lowering some more. In any case, don’t try these approaches on your own; work with your doctor.
Some women quit hormones more than once — “five times and counting,” says Kalell — and some stay on for years, having decided that it’s reasonably safe for them. It’s critical to report unusual symptoms, especially unexpected bleeding or spotting, a possible warning sign of cancer, and to be scrupulous about mammograms. It’s also important to keep revisiting the question of risk and benefit, especially as you get older and your health issues change.
Originally published on March 27, 2008
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