Afraid of menopause and hormonal therapy?

Menopause should be spelled ‘meanopause.’ It turns some women into mean, ill-tempered creatures," quips the man who reveals that his wife of several decades was turning into a veritable virago. The turnaround from the kind, considerate, and patient person that she once was to the irritable complainer was unnerving, especially since no one could predict when her volatile temper would go off. For the wife, the life-stage was difficult as well. The various aches and pains terrified her as she suspected that these were symptoms of a terminal illness.

Teresita Guzman, a 52-year-old businesswoman and mother to three sons can relate with the experience. "I was suffering from hot flushes, which caused me a great deal of discomfort," she says. "Even the most minor things irritated me, so that I found myself losing my temper and raising my voice many times."

Fortunately, a sibling recognized the symptoms of menopause and advised Mrs. Guzman to consult a gynecologist.

What is menopause?

Dr. Joan Tan Garcia, reproductive endocrinology, infertility and menopause specialist at St Luke’s Medical Center and Manila Doctor’s Hospital, explains that biological changes occur when a woman reaches the stage where she no longer menstruates. There is a rapid decline in ovarian function, leading to reduced production of sex hormones principally estrogen. As her body reacts to the change, the menopausal woman may experience a range of symptoms that can make her quality of life deteriorate.

"Hormonal changes can cause symptoms such as joint pain, backache, mood disorders, reduced energy and drive, difficulty in sleeping, hot flushes, and urogenital symptoms," elaborates Dr. Tan Garcia. "A woman may experience drying and thinning of the vagina, incontinence, vaginal itch, pain and discomfort during sexual intercourse which, in turn, may result in sexual dysfunction, including reduced libido." 

In addition, scientific studies indicate a higher prevalence of osteoporosis or porous bones among menopausal women. The risk of high blood pressure (BP) or hypertension also increases significantly at menopause. This is especially disturbing because persistently high BP is a powerful risk factor for cardiovascular disease (CVD), the leading cause of disease and death in women aged 50 years and above in developed countries.

Is there a cure for menopause?

Dr. Tan Garcia is quick to clarify that menopause is not a disease but a life-stage — a natural and irreversible process that women in the early to mid 50s experience. To relieve the symptoms that accompany it, doctors may prescribe hormonal therapy (HT) to compensate for the natural reduction in estrogen.

At the Insights into Menopause Management in Asia Pacific press conference organized by Bayer Healthcare and held in Taipei, Taiwan recently, Dr. David Sturdee, secretary general of the International Menopause Society, declared the stand of his organization: "Hormone therapy should be part of an overall strategy including lifestyle recommendations regarding diet, exercise, smoking, and alcohol for maintaining the health of postmenopausal women."

Aside from improving sexuality and overall quality of life by alleviating urogenital symptoms and other menopause-related complaints, HT prevents postmenopausal osteoporosis and has a protective effect on bone mineral density, thereby reducing the risk of bone fractures.

There is evidence that HT may be cardio protective if started around the onset of menopause and continued long-term. Dr. Sturdee calls this the "window of opportunity" concept. Likewise, HT reduces the risk of diabetes and has positive effects on other risk factors for cardiovascular disease, such as the lipid profile and metabolic syndrome.

The benefits of HT do not end there. Various studies also show that it has benefits for connective tissue, skin, joints and intervertebral disks. It may reduce the risk of colon cancer; and if the therapy is initiated around the time of menopause, it is associated with lower risk for Alzheimer’s disease.

So, why be afraid of HT?

Some women prefer to forgo hormonal therapy and suffer the symptoms of menopause because of the notion that it increases the risk of breast and endometrial cancer. "The risk of breast cancer associated with HT is very small. It is less than 0.1 percent per annum," says Dr. Sturdee. "By far, the benefits of hormone therapy outweigh the possible risks."

However, a physician should supervise hormonal therapy. It should be individualized and tailored according to symptoms and women should have regular consultation with their physicians for physical examination, update of medical history, relevant laboratory examinations, and a discussion on lifestyle.

The International Menopausal Society recommends that: "dosages should be titrated to the lowest effective dose," although "there are no limitations on the length of treatment."

"The progressive loss of estrogen during menopause increases women’s health risk and will affect their quality of life at a time when they should be enjoying the fruits of their labor and success," explains Dr. Sturdee. Perhaps this is why menopausal women should consider hormonal therapy. The new medications available on the market may help a woman to age even more happily, gracefully, and beautifully.

Ask your physician about hormonal replacement therapy and Bayer Healthcare’s new improved therapy option.