Menopause

Menopause is defined as the point in time when menstrual periods have stopped for 12 consecutive months. This reflects the ovaries’ cessation of hormone (primarily estrogen and progesterone) production. Menopause typically occurs between ages 45–55, though it may occur earlier (e.g. surgically induced). 

After menopause, lower estrogen levels contribute to changes in vasomotor regulation, bone metabolism, urogenital tissues, lipid metabolism, and other systems.

Common symptoms & long-term effects

  • Hot flashes, night sweats

  • Vaginal dryness, painful intercourse, urogenital atrophy (loss of tissue), urinary problems

  • Sleep disturbances, insomnia

  • Mood changes, irritability, low mood

  • Increased risk of osteoporosis / bone fractures

  • Changes in skin, hair, metabolism (weight gain, fat redistribution)

  • Increased risk (long-term) of cardiovascular changes, lipid changes, possible cognitive changes

Common hormone therapy (HRT) prescriptions

Hormone therapy for menopause — often referred to as HRT (hormone replacement therapy) or MHT (menopausal hormone therapy) — is tailored based on many factors and primary symptoms. 

Typical regimens include:

  • Estradiol therapy (E2) — oral, transdermal patch/gel, vaginal ring/cream, spray, etc. 

  • Progesterone therapy (OMP) — to reduce risk of endometrial and breast cancer.

  • Local (vaginal) estrogen therapy — for urogenital symptoms such as dryness, atrophy, urinary symptoms (lower dose, local application). 

  • Testosterone therapy — for symptoms of low libido, low mood, drive, or motivation, improve well-being. Oral, transdermal cream, or injection.

  • DHEA — Women experiencing cognitive or vaginal symptoms may also benefit from DHEA supplementation.

Formulations and routes vary and are selected based on symptom profile, risk factors, and patient preferences.

How hormone therapy improves symptoms & health risks

When used appropriately, HRT may:

  • Relieve vasomotor symptoms (hot flashes, night sweats), improving sleep and quality of life. 

  • Treat urogenital atrophy, improving vaginal dryness, discomfort, and urinary symptoms. 

  • Protect bone health, reducing risk of osteoporosis and fractures. 

  • Improve mood, sleep, and overall well-being in many users. 

  • Potentially improve metabolic health and lipid profiles (though benefits vs. risks vary depending on timing, type of therapy, and individual factors). 

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Perimenopause

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Andropause