Scroll Top

Menopausal Hormone Therapy

If you and your healthcare provider decide that your symptoms require hormone therapy, here is some background we think you should know.

Menopausal hormone therapy (MHT) is generally used in post-menopause after the final menstrual period

Did you know? The doses of hormones used in menopausal hormone therapy are generally much lower than the doses used in birth control pills. 

The most common hormone used in menopausal hormone therapy is estrogen. And for women who have not had a hysterectomy (that is, they still have a uterus), a progestogen (a progesterone-like product) must be used to protect the uterus from endometrial cancer. For this reason, many women in menopause are prescribed both estrogen and a progestin — the same two ingredients that are in birth control pills.

OTHER RESOURCES IN THIS SECTION
A chart of all MHT products
MHT products chart
Progesterone and progestins – a difference?
Progesterone and progestins
Understand compounded MHT products
Compounding overview
The tumultuous history of MHT
MHT history

Why many healthcare providers prescribe birth control pills for symptomatic perimenopausal women

First, perimenopausal women are still making hormones. As a result, their hormone levels are fluctuating within a cycle and between cycles. The pill works by overriding and shutting down your own hormone production. This is viewed as preferable to hormone therapy, which adds lower doses of hormones, but on top of what is already being produced by your body. However, menopausal hormone therapy, because a lower dose is used, doesn’t shut down hormonal production and a woman can end up with levels that are too high, making symptoms worse.

Second, the other benefit of using a birth control pill to manage symptoms is that it takes care of pregnancy prevention for those that want that since you can still get pregnant in perimenopause.

DEFINING MENOPAUSAL HORMONE THERAPY (MHT)

Pharmaceutical products used to mitigate symptoms associated with hormonal fluctuations during perimenopause and after menopause.

Former names: Hormone Therapy (HT) and hormone replacement therapy (HRT).
  • Adding “menopausal” differentiates it from other hormone therapies like thyroid and insulin therapies.
  • “Replacement” erroneously suggests that lower hormone levels during the menopause transition need to be replaced. They don’t!

What symptoms is MHT approved for?

  • Hot flashes and night sweats (vasomotor symptoms)
  • Vulvovaginal changes
  • Bone loss prevention (however, if this is your only goal, there are other better therapies)

Some healthcare providers will try MHT “off label” (meaning it’s not been studied and FDA approved) for other symptoms when nothing else is working. These are:

  • Sleep
  • Mood
  • Joint pain

MHT has not been found in replicable studies to work for:

  • Heart health
  • Brain health
HORMONAL REMEDIES
  • Estrogen Therapy (ET) for those without a uterus
  • Estrogen and Progesterone Therapy (EPT) for those with a uterus

Find an overview of specific product options for hormone therapy here.

Understand the differences between FDA-approved products and compounded products here.

FEATURED RESOURCES