Who should not take Menopause Hormone Therapy (MHT)?

Hot flashes. Brain fog. Weight gain. Mood swings. Night sweats. If you’re sweating through your clothes, leaving your phone in the fridge, or not on speaking terms with your scale, menopause hormone therapy (MHT) might seem like the obvious answer. 

MHT can be a game-changer for many women and help them feel more like themselves instead of just powering through menopause and perimenopause. However, understanding if MHT is right for you doesn’t just depend on your symptoms, but also hinges on an honest discussion with your doctor about your personal health history. 

Who isn’t a good candidate for hormone replacement therapy (HRT) / menopause hormone therapy (MHT)?

While menopause hormone therapy (MHT) can bring life-changing relief to many women, it’s not right for everyone. You may have seen this treatment called HRT (hormone replacement therapy), but doctors have moved away from that because the term “replacement” suggests something is wrong and needs to be fixed. MHT has been chosen as a better fit because menopause is a normal stage of life, and this therapy is about managing symptoms through individualized care. 

Dr. Sheryl Ross (Dr. Sherry), Chief Medical Officer of Women’s Health at QuickMD, says that women with the following health histories should avoid MHT:

• Personal history of breast, ovarian or endometrial cancer 
• Strong family history of breast cancer
• History of blood clots, stroke, or heart disease 
• Liver disease (active or severe)
• Untreated high blood pressure
• Abnormal vaginal bleeding
• Pregnancy or plans to become pregnant
  

If you fall into one of these categories, it doesn’t mean you’re stuck dealing with severe symptoms. Your doctor can work with you to explore alternative treatments like Selective Serotonin Reuptake Inhibitors (SSRIs) for hot flashes or exercise for mood and bone health.

Who can benefit from menopause hormone therapy (MHT)?

For many women, menopause hormone therapy is safe and can ease the frustrating symptoms that disrupt life the most. MHT can be systemic, meaning it treats the entire body, or local, meaning it targets a specific area.

If you start MHT before age 60 or within 10 years of menopause, the benefits may outweigh the risks. If you’re thinking about MHT, you may especially benefit from it if you:

• Struggle with hot flashes: Hot flashes hijack moments in your day, but systemic MHT is the most effective treatment available compared to lifestyle changes and non-hormonal prescription drugs.
• Feel exhausted from poor sleep: Losing sleep night after night is nothing short of a waking nightmare. Systemic MHT relieves night sweats, which can improve overall sleep quality.
• Have vaginal dryness: Dryness can interfere with your sex life and overall comfort. Local MHT creams, tablets, or rings can help restore moisture and ease discomfort.
• Feel the haze of brain fog: Brain fog often gets overlooked, but systemic MHT can help clear it by reducing hot flashes and improving sleep quality.
• Experience mood changes: Irritability, anxiety, and depression can stem from fluctuating hormone levels and poor sleep. Systemic MHT helps stabilize hormones, which stabilizes mood. 
• Need support for bone health: Estrogen protects bones and prevents bone loss, so lower levels during menopause increase the risk of osteoporosis. Systemic MHT is proven to be highly effective in preserving bone health. 
• Have early menopause: If you’ve had your ovaries removed or are going through early menopause, MHT can help lower your risk for conditions such as osteoporosis and heart disease. 

Let’s discuss whether you’re a candidate for MHT

Think MHT might be right for you? Here at QuickMD, our team of doctors understands women’s health and menopause care. We can help you determine if MHT is right for you. Even if you saw yourself in one of the conditions Dr. Sherry mentioned, that doesn’t mean you’re out of options. There may be alternative treatments or specific circumstances where MHT could still work for you.