It has been almost a decade since the federal government called an early halt to a large national study of the effectiveness of menopausal hormone therapy because of safety concerns. In the years since then, many women have struggled with whether to take hormones to relieve menopausal symptoms.
Today, far fewer women choose to take hormone therapy at menopause, but those who do are faced with another difficult decision: when should they stop?
Most studies to date suggest that women who are entering menopause naturally (and not because of surgery or another medical condition) can take estrogen and a progestin with reasonable safety for a few years to ease severe hot flashes. However, that's not the case if there's a history of breast cancer or heart disease in your family so be sure and discuss your entire medical history with your doctor.
After a couple of years, many women try to get off menopausal hormone therapy, hoping that the worst of their symptoms have ended. That's true for at least half of women who quit, according to studies. But the other half will likely experience what some doctors call "rebound hot flashes" – the same symptom that made them want to go on menopausal hormone therapy in the first place. No one can predict which group a woman will fall in until she tries to stop.
You might think that stopping gradually would help but there's no evidence that this is true. Some women are able to quit cold turkey with no symptoms; others can't.
So if you are trying to stop and the hot flashes have come back, here are a few quick tips:
· Give yourself a few weeks to see if the symptoms get better with lifestyle changes.
· Don't quit in a heat wave. Ambient temperature can trigger hot flashes.
· If you experience any bleeding after you stop, call your doctor. This can be normal, but any bleeding after menopause is a cause for concern.
· If you are tapering off gradually, ask your doctor about slowing down the process even more. That might help.
· Ask your doctor about other medication, such as some anti-depressants, that have been shown to relieve hot flashes.
· Finally, never tamper with any medication schedule without talking to your doctor. He or she has access to all the latest medical information that can help you get through this.