DEAR MAYO CLINIC: I've just started going through menopause. The hot flashes and night sweats are so uncomfortable and keep me up at night. I've heard about hormone therapy — could that be an option for me? Are there any risks?

ANSWER: Navigating menopause and its symptoms can be exhausting. To give you more information about hormone therapy, we must start with menopause. Menopause marks the end of your menstrual cycle and is diagnosed after 12 months without a menstrual period. The average age at which menopause begins in the U.S. is 51, but it can begin in your 40s. In the months or years leading up to menopause, women may experience:

• Hot flashes
• Night sweats
• Trouble sleeping
• Chills
• Irritability or mood changes
• Weight gain
• Irregular periods
• Hair thinning
• Dry skin

Hormone therapy can help manage a lot of these symptoms. Hormone therapy is medication containing hormones that your body stops producing during menopause. Hormone therapy is a safe option for the average healthy woman. Keep in mind, though, it is not for everybody.

There are many different options available for treatment. In general, transdermal therapies (therapies applied directly to the skin) are considered among the safest ways to administer hormone therapy. For example, there are patches that can be worn on the lower abdomen or buttock, gels can be applied to the inner thigh and sprays which go on the forearm. There are also oral routes you can take. Because of all the options we have nowadays, we usually are able to find an option that meets the average woman's specific needs.

After starting hormone therapy, many women experience complete or near complete resolution of hot flashes. If not, we aim to reduce them significantly enough to improve quality of life and help women regain a sense of normalcy. Hormone therapy may help many of the other symptoms women experience related to menopause such as mood changes, trouble sleeping, brain fog, skin changes and hair loss, to name a few. While these are common symptoms associated with menopause, we do not want to miss any more serious or underlying issues. So, it is best to talk to your doctor and ensure that any other potential contributing factors or underlying medical conditions are addressed. Hormone therapy has also been proven to prevent bone loss and reduce fractures in women post-menopause.

If hormone therapy is not the right fit for you, there are several non-hormonal therapies that can be considered. Cognitive behavioral therapy and hypnosis have also been shown to ease menopausal symptoms.

It is important to maintain a healthy lifestyle while undergoing hormone therapy. This includes staying physically active, not smoking, managing stress, eating a nutritious diet and maintaining a healthy weight. It is also important to keep up with all routine health screenings like mammograms, colonoscopies, bone density studies and routine physicals.

There are a lot of questions about the safety of hormone therapy — "Does it cause breast cancer? Will it increase my risk for dementia, heart attack and stroke?" For the average healthy woman who is close to the menopause transition and younger than the age of 60, hormone therapy is typically a very safe option. Many of the risks associated with hormone therapy can be lessened by starting hormone therapy at the right time (within 10 years of menopause and before age 60), using transdermal therapy and maintaining a healthy lifestyle. Talk to your healthcare team or a women’s health specialist if you are considering hormone therapy and aren’t sure if it’s right for you. — Taryn Smith, M.D., Women's Health, Mayo Clinic, Jacksonville, Florida

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