The Ups and Downs of Hormones

(This article was written by Frisco OBGYN Dr. Jonathan Weinstein for Baylor of Plano)

You blame hormones for your monthly acne breakouts and your mood swings. They lay at the heart of your perimenopausal hot flashes, insomnia, and mood swings. However, while they often get a bad rap, hormones are not necessarily as bad as they’ve been portrayed. They are simply chemicals that affect growth and development, your metabolism, sexual function, reproduction, and mood.

For women, hormones are particularly important to understand during menopause, a time when your natural estrogen levels are dropping. Together, you and your doctor have decisions to make about how to handle those changes, explains Jonathan Weinstein, M.D., an OB/GYN on the medical staff at Baylor Regional Medical Center at Plano.

Understand the past. “When I graduated, we were told to give everyone hormone replacement,” Dr. Weinstein says. “We were told it would help prevent heart attacks, strokes, Alzheimer’s disease, and more.”

In 2002, things changed when the Women’s Health Initiative showed that Prempro®, a common hormone therapy drug that combined Premarin® and progestin, actually increased women’s risks for breast cancer, heart disease, and strokes.

“After 2002, nearly every primary care doctor in the country stopped giving patients hormone replacement therapy,” Dr. Weinstein says. “I don’t mind giving hormones as long as people know the risks and benefits. Benefits include a sense of well-being and the prevention and treatment of osteoporosis among others.”

Know the current data. Women going through menopause are likely to experience hot flashes, irritability, mood swings, bladder problems, and more, Dr. Weinstein says. Moreover, the estrogen withdrawal, he explains, causes the skin to become less elastic leading to changes of the genitalia that can result in pain during intercourse, vaginal dryness, urinary incontinence, and difficulty with bowel movements.

Today, Dr. Weinstein says, “several hormone therapy replacement options that have better safety profiles are available.” Doses also tend to be lower than 10 years ago, he says, and beyond pills, options include patches and gels that contain estrogen and progesterone.

Choose your future. Ultimately, hormone therapy is a choice you and your doctor should make together.

“There are potential risks, but you have to weigh those risks against the benefits,” Dr. Weinstein says. “If women don’t take hormones, they’ll make it through menopause, but they’ll have an increased risk for mood swings, anxiety, and depression.”

Those who are opposed to hormones, he adds, might consider anti-depressants to help with mood and hot flashes as well as other medications for osteoporosis prevention.

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