Step 4: Read and complete the decision guide to learn more about your symptoms.
Since you are having both hot flashes and vaginal dryness, you may want to take estrogen replacement in a dose that is adequate to relieve both of these symptoms. In general, this requires systemic (oral or patch form) estrogen. Here are some risks and benefits that you and your doctor will need to consider together if you are interested in using estrogen at a dose that is adequate for your hot flashes. In your case, the risks that are listed include risks for women who take both estrogen and progesterone.
Risks from estrogen with progesterone:
- You are more likely to get breast cancer; for a 50-year-old woman taking these hormones to treat hot flashes, there is about a one in 100 chance that she will develop breast cancer that would not have developed without hormone treatment
- You are more likely to have a stroke
- You are more likely to get a blood clot in your leg or your lungs (pulmonary embolus)
- You are more likely to develop dementia
- You are more likely to get gallstones
There are some benefits from estrogen with progesterone:
- Relief from hot flashes
- A lower risk for urinary tract infections
- Slightly lower colon cancer risk
- Increase in bone density and decreased risk of bone fractures (however, other non-hormonal treatments are available to improve your bone density)
- Relief from vaginal dryness
Studies have also revealed that short-term treatment does not appear to worsen -- nor to improve -- heart attack risk when it is used in women under the age of 60. However, for older women, estrogen with progesterone increases heart attack risk.
Women who choose hormonal therapy to treat hot flashes usually start near the time of menopause and use it for five years or less. This is considered short-term treatment. Short-term estrogen with progesterone therapy is a reasonable option for women who are very bothered by hot flashes.
Visit with your doctor if you would like to consider treatment with estrogen and progesterone for your hot flashes.
If your hot flashes are not very bothersome, or if you have already used estrogen for five years and have discontinued it, you may want to consider treatments other than systemic (oral or patch) estrogen for your vaginal dryness.