Hormone Therapy for Menopause

What is hormone therapy for menopause?

Menopause is the time in a woman's life when her menstrual periods stop. It is a normal part of aging. During menopause, the body makes much lower amounts of the hormones estrogen and progesterone.

Hormone therapy for menopause involves taking estrogen, with or without progesterone (or a similar hormone called progestin). The goal is to replace some of the hormones the body no longer makes and help relieve menopausal symptoms.

In the years leading up to menopause, and during menopause, hormone levels can rise and fall. These changes can cause symptoms for some women that may be mild and go away on their own. For others, symptoms may be more severe and affect daily life.

Lower hormone levels during menopause can cause symptoms such as:

• Hot flashes
• Night sweats
• Mood changes
• Vaginal dryness
• Pain during sex

Hormone therapy may help relieve these symptoms. It may also help protect against osteoporosis.

Hormone therapy is not right for everyone. You should not use hormone therapy for menopause if you:

• Are pregnant or think that you may be pregnant
• Have unexplained vaginal bleeding
• Have had certain types of cancer
• Have had a stroke or heart attack
• Have had blood clots
• Have liver disease

Talk with your health care provider about your medical history before starting hormone therapy.

There are different types of hormone therapy for menopause. If you had surgery to remove your uterus (hysterectomy) your provider may recommend estrogen only therapy. If you still have your uterus, your provider may recommend estrogen plus progesterone (or progestin) therapy.

Hormone therapy for menopause comes in several forms. Most are pills taken by mouth, but there are also skin patches, gels or sprays, vaginal creams, tablets, or rings.

Your provider can help you choose the type and form that's best for you.

Hormone therapy has some risks. For some women, it may increase the risk of:

• Blood clots
• Heart attack
• Stroke
• Breast cancer
• Gallbladder disease

The level of risk depends on the type of hormone therapy, how long it is used, and your medical history and lifestyle.

You and your provider should talk about the risks and benefits. If you decide to use hormone therapy, it is usually recommended to use the lowest dose that helps and for the shortest time needed. Ask your provider how often you should follow up. Many recommend checking in every three to six months at first, then once a year after treatment is working well.

Food and Drug Administration

How Much Exercise Do I Need?

Regular exercise is one of the best things you can do for your health. It has many benefits. It can improve your overall health and fitness and reduce your risk for many chronic diseases. To get the most benefit, here's how much physical activity you should get:

Get at least 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity aerobic physical activity each week. Or you could do a combination of the two:

• Try to spread your physical activity out over several days of the week. That's better than trying to do it all in one or two days.
• Some days you may not have long blocks of time to do physical activity. You can start slowly and break your exercise time into chunks. Even small amounts of exercise can be helpful.
• Aerobic activities include walking fast, jogging, swimming, and biking.
• Moderate intensity means that while you are doing that activity you should be able to say a few words in a row but not sing.
• Vigorous intensity means that while you are doing that activity, you won't be able to say more than a few words without stopping for a breath.

Also, do strengthening activities two or more days per week:

• Strengthening activities include lifting weights, working with exercise bands, and doing sit-ups and pushups.
• Choose activities that work all parts of your body your legs, hips, back, chest, stomach, shoulders, and arms. For each exercise, try repeating the movement 8 to 12 times. As you get stronger, work up to doing 2 or 3 rounds of each exercise for the best results.

If you are an older adult, you may also benefit from a combination of activities that include aerobic exercises, strength or resistance training, and balance training. Balance training such as walking heel-to-toe or standing on one leg may help improve stability and prevent falls. Before you start exercising, check with your health care provider to determine the best type or amount of activity for you based on your fitness level and health.

Preschool children should be physically active throughout the day, to help with their growth and development:

• They should get both structured and unstructured active play. Structured play has a goal and is directed by an adult. Examples include playing a sport or a game. Unstructured play is creative free play, such as playing on a playground.
• Encourage active play with a variety of activities.

Get 60 minutes or more of physical activity every day. Most of it should be moderate-intensity aerobic activity:

• Activities should vary and be a good fit for the child's age and physical development
• Moderate-intensity aerobic activities include walking, running, skipping, playing on the playground, playing basketball, and biking

As part of the 60 minutes or more of daily physical activity, try to do each of these at least 3 days a week: vigorous-intensity aerobic activity, muscle-strengthening activity, and bone-strengthening activity:

• Vigorous-intensity aerobic activities include running, jumping jacks, and fast swimming
• Muscle-strengthening activities include playing on playground equipment, playing tug-of-war, and doing pushups and pull-ups
• Bone-strengthening activities include hopping, skipping, jumping jacks, playing volleyball, and working with resistance bands

Older adults, pregnant women, and people who have disabilities or special health needs should check with their provider on how much physical activity they should get and what types of activities they should do.

People who are trying to lose weight may need to get more physical activity. They also need to adjust their diet, so they are burning more calories than they eat and drink.

If you have been inactive, you may need to start exercising slowly. You can keep adding more gradually. The more you can do, the better. But try not to feel overwhelmed and do what you can. Getting some physical activity is always better than getting none. Even small increases in exercise can benefit your health.

NIH: National Heart, Lung, and Blood Institute

Kidney Transplantation

A kidney transplant is an operation that places a healthy kidney in your body. The transplanted kidney takes over the work of the two kidneys that failed, so you no longer need dialysis.

During a transplant, the surgeon places the new kidney in your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Often, the new kidney will start making urine as soon as your blood starts flowing through it. But sometimes it takes a few weeks to start working.

Many transplanted kidneys come from donors who have died. Some come from a living family member. The wait for a new kidney can be long.

If you have a transplant, you must take drugs for the rest of your life, to keep your body from rejecting the new kidney.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Laboratory Tests

Laboratory tests check a sample of your blood, urine, or body tissues. A technician or your doctor analyzes the test samples to see if your results fall within the normal range. The tests use a range because what is normal differs from person to person. Many factors affect test results. These include:

• Your sex, age and race
• What you eat and drink
• Medicines you take
• How well you followed pre-test instructions

Your doctor may also compare your results to results from previous tests. Laboratory tests are often part of a routine checkup to look for changes in your health. They also help doctors diagnose medical conditions, plan or evaluate treatments, and monitor diseases.

Low Blood Pressure

You've probably heard that high blood pressure is a problem. Sometimes blood pressure that is too low can also cause problems.

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps out blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure. Your blood pressure reading uses these two numbers. Usually they're written one above or before the other, such as 120/80. If your blood pressure reading is 90/60 or lower, you have low blood pressure.

Some people have low blood pressure all the time. They have no symptoms and their low readings are normal for them. In other people, blood pressure drops below normal because of a medical condition or certain medicines. Some people may have symptoms of low blood pressure when standing up too quickly. Low blood pressure is a problem only if it causes dizziness, fainting or in extreme cases, shock.

NIH: National Heart, Lung, and Blood Institute