BENEFITS OF MHT
You can usually begin menopausal hormone therapy (MHT) as soon as you start experiencing menopausal symptoms and, in doing so, will increase your long-term health benefits.
A GP or gynaecologist can explain the different types of MHT available to you and help you choose one that's suitable for you. It is normally recommended to start with a low dose, which may be increased at a later stage. Combined MHT contains oestrogen and progesterone. Continuous combined MHT is designed to cause no bleeding. It can be started after one year of no periods. If you have not experienced a one year gap of no periods, your GP will recommend a sequential or cyclical combined preparation, which will result in a predictable bleeding pattern and reduce the risk of erratic bleeding due to residual ovarian activity.
Irregular bleeding is common with all regimens, particularly during the first 3–6 months of use. After this time, abnormal bleeding should be investigated with pelvic ultrasound to assess endometrial thickness +/- hysteroscopy and curettage (D and C). Most women stop MHT due to progestogenic side effects, namely mood changes, bloating, headaches and mastalgia. Sometimes changing the progestogen preparation or mode of delivery can help.
What are the benefits?
The main benefit of MHT is the relief of menopausal symptoms. These symptoms are caused by reduced levels of oestrogen and include hot flushes, night sweats, disturbed sleep, irritability and vaginal dryness. Longer term, it can mitigate the risk of reduced bone mineral density and cardiovascular disease.
There is a significant amount of evidence that systemic MHT benefits menopausal symptoms, such as those listed above. These benefits can lead to better quality sleep, improved sexual relations and quality of life.
The main indications for commencing MHT are hot flushes, night sweats, vaginal dryness and osteoporosis.
How long before symptoms improve?
It usually takes several weeks before you will feel the initial benefits of MHT such as improved sleep, reduced hot flushes, improved concentration, reduced aches and pains, increased energy, improved mood and improved skin and hair quality. The full effect may take up to three months. It may also take your body time to adjust to MHT.
When you first take MHT, you may experience side effects such as breast tenderness and swelling, irregular bleeding, fluid retention, bloating and nausea. These symptoms often subside with time; however, should these side effects persist, you may need to see your doctor for a different type of MHT or dosage adjustment.