Why Progesterone Replacement Therapy is Prescribed with Estrogen

by SXHH Marketing | May 6, 2022 | Hormone Replacement Therapy, Menopause

If you’re considering hormone therapy for menopause symptoms, you may have noticed that most doctors recommend taking progesterone replacement therapy with estrogen unless you’ve had a hysterectomy. Many people wonder why this is. You might wonder if you really need progesterone to treat menopause symptoms like hot flashes. Let’s talk about why our providers frequently prescribe both progesterone and estrogen for women in menopause.

Summary

• Progesterone is usually prescribed with estrogen for women who still have a uterus. While estrogen can be very effective for menopause symptom relief, it can also cause the uterine lining to thicken. Progesterone helps balance that effect and lowers the risk linked to estrogen-only therapy.
• As hormone levels decline, symptoms like hot flashes can become more noticeable. Combination hormone therapy like progesterone and estrogen may help reduce these symptoms while also supporting safer treatment for some women.
• Not every woman needs progesterone with estrogen therapy. Women who have had a hysterectomy are often prescribed estrogen alone because there is no uterine lining to protect. In those cases, avoiding unnecessary progesterone may help reduce added long-term risk.
• Hormone replacement therapy should be tailored to each woman’s needs and health history. At HerKare, our providers offer personalized, effective care plans that will help you feel like you again.

What is Progesterone Replacement Therapy?

Progesterone replacement therapy may be an important part of your menopause care plan.

Progesterone replacement therapy is just like any other hormone replacement therapy (HRT) in that it supplements and replaces natural levels of a hormone in your body. In this instance, the hormone is progesterone. Like other types of HRT, it comes in many forms and doses. For women who still have their uterus, progesterone is almost always prescribed with estrogen therapies.

What Does Progesterone Do?

Progesterone is a type of sex hormone in your body, like estrogen and testosterone. Many people refer to progesterone as the “pregnancy hormone,” as it’s important for making the uterus a good environment for a fertilized egg. It also does many other things during pregnancy, like helping your breasts get ready to produce breast milk.

However, progesterone has many other functions in the body. Progesterone and estrogen work in tandem to regulate the menstrual cycle before menopause. Estrogen grows the uterine lining (the endometrium) and helps your body get ready for ovulation. Progesterone, on the other hand, helps prepare the uterus to receive a fertilized egg and, if you don’t become pregnant, levels drop and cause you to have your period.

During menopause, both estrogen and progesterone levels drop and become more sporadic. This is what causes irregular periods and other symptoms associated with perimenopause. As you produce less and less, you stop having periods altogether and reach menopause.

Progesterone Replacement Therapy Paired with Estrogen for Menopausal Women

Fluctuating and declining hormone levels are the cause behind menopause symptoms like hot flashes, night sweats, mood changes, and sleep problems. These symptoms can range from bothersome to debilitating for some women. If you experience symptoms that interfere with everyday life, our hormone doctor may recommend starting a hormone replacement therapy regimen to help reduce your symptoms. If you still have your uterus, you will likely need to take both progesterone and estrogen for menopause treatment. This is also known as combination hormone replacement therapy.

Why You Need Both Estrogen and Progesterone if You Still Have Your Uterus

You might be wondering why progesterone replacement therapy is so important if you still have your uterus. The reason is that estrogen alone, while effective for treating many menopause symptoms, can cause the lining of your uterus to become too thick. Before menopause, the uterine lining thickens and then your body sheds it during your period, but this process stops after your last period. The problem is, if the uterine lining becomes too thick, it can increase the risk for endometrial cancer. Therefore, estrogen-only therapy may increase your risk for uterine cancer.

Progesterone comes to the rescue here because it stops the thickening process. This hormone keeps estrogen in balance to reduce the uterine cancer risks associated with estrogen replacement therapy. Therefore, if you still have a uterus, progesterone replacement therapy is essential for reducing risks associated with estrogen-only treatments.

Are There Risks of Estrogen and Progesterone Replacement Therapy?

Like any other medication or treatment, there are risks to taking combination hormone replacement therapy. Specifically, researchers believe that higher progesterone levels can increase the risk for breast cancer. Data from the Women’s Health Initiative suggest that combining progesterone and estrogen can increase a woman’s risk for developing breast cancer by about one-tenth of a percent per year.

While the risk is relatively low, it’s important to weigh this drawback against the potential benefits of combination therapy. Also, many experts suggest not taking progesterone unless needed to reduce risks of uterine cancer from estrogen-only treatments. Though, it’s important to understand that hormone replacement therapy is a really individualized treatment. There is no one approach that fits all women. Therefore, you should talk about your individual circumstances with our providers.

Is Progesterone Replacement Therapy Ever Prescribed On Its Own?

We’ve talked a lot about combining estrogen and progesterone replacement therapy to treat menopause symptoms. However, you might be wondering if progesterone is ever used on its own for menopause. This isn’t a very common treatment plan because most menopause symptoms are due to low estrogen levels. However, some studies have found that progesterone alone can help reduce hot flashes, night sweats, sleep disturbances, and other common symptoms of menopause. Still, estrogen replacement therapy is currently the most effective option for treating these symptoms for menopausal women, which makes it the go-to treatment solution.

Who Doesn’t Need Progesterone Replacement Therapy for Menopause Symptoms?

Not everyone needs to take progesterone with estrogen for hormone replacement therapy. In fact, estrogen alone comes with fewer long-term risks for women who do not have a uterus. In these cases, our providers may recommend estrogen-only therapy because there is no need to worry about the increased risk for endometrial cancer. As we mentioned, the risk of adding progesterone to your treatment regimen is a slightly increased risk for breast cancer. Therefore, if you have had a hysterectomy, typically we recommend estrogen-only options to reduce this risk.

How Does Combination Estrogen and Progesterone Replacement Therapy Work?

If your hormone doctor prescribes combination hormone replacement therapy, this means you will take both estrogen and progesterone to help treat your menopause symptoms. There are a couple of different ways to go about this. One may work better for you than the other. Our doctors can discuss your individual needs and find a treatment plan that works best for you. However, here are some things to know about continuous and cyclical menopausal hormone therapy:

Continuous Combination Hormone Replacement Therapy

Continuous combination hormone therapy means you take both estrogen and progesterone replacement therapy for treatment. This option is where you take both bioidentical hormones every day to reduce symptoms and health risks during menopause. This often makes treatment simpler and easier to use for many people, as the treatment is the same each day. Continuous HRT also reduces or eliminates vaginal bleeding, which can occur with cyclical hormone therapy.

Cyclical HRT

Cyclical hormone therapy looks a little different for everyone, and there are many ways to go about this treatment plan. For instance, some women take estrogen only for a certain period of time, usually about 14 days, then use progesterone and estrogen for about 11 days. For the remaining three to five days, they do not take hormones. The idea is to mimic hormone levels during an average menstrual cycle. However, other women take estrogen every day for several months (usually about three months) and then take progesterone replacement therapy with estrogen for about two weeks or so after that time. Your hormone doctor can help you determine if this type of hormone replacement therapy is right for you.

One of the benefits of cyclical HRT is that it can reduce your exposure to progesterone over time, which may help offset some of the risks associated with progesterone replacement therapy. However, some of the disadvantages include a more complicated treatment plan to remember and maintain, as well as possible menstrual-like bleeding on the days you take progesterone and estrogen together. So, it’s important to discuss the options with our providers and find the option that works best for you.

Get Individualized Care from an Experienced Hormone Doctor at HerKare Women’s Clinics

Our professionals at HerKare are here to help you improve your health and quality of life through personalized treatment plans. We understand the need for individualized care tailored to you and your lifestyle. Our providers work hard to find underlying causes of your symptoms and identify treatment solutions that work well for you. If you’re experiencing menopause symptoms, know that our team is here to help you find relief. Book an appointment today at one of our convenient locations to talk to our doctors about your symptoms and treatment options!

Can HRT Help with Anxiety During Menopause?

by SXHH Marketing | Apr 6, 2022 | Hormone Replacement Therapy, Menopause

Menopause comes with many changes. Many women experience disruptive symptoms like hot flashes and insomnia. Another issue that people don’t seem to talk about as much is anxiety. Anxiety during menopause may be due to several factors, including hormone fluctuations during and after menopause. Because hormones can have such an impact on mood and anxiety, hormone replacement therapy (HRT) may help alleviate your symptoms. Let’s talk about menopause, anxiety, and HRT.

HRT Can Help Alleviate Menopause Symptoms

Say goodbye to menopause symptoms with HRT to balance your hormones.

Before we get into HRT for menopausal anxiety, let’s go over what HRT is and why you may need it during menopause. Hormone replacement therapy refers to medications that supplement your natural hormone levels. During menopause, women may have a regimen of estrogen and progesterone to help even out hormone levels. Many women also take testosterone replacement therapy.

The goal for HRT is to alleviate menopause symptoms, which are typically brought on by low and imbalanced hormone levels. During menopause, our bodies start to produce significantly less estrogen, progesterone, and testosterone. Levels may fluctuate leading up to our last period, sometimes being higher or lower than normal. After we reach our last period and enter post-menopause, our ovaries produce much less of the sex hormones estrogen and progesterone.

These hormone changes can cause many symptoms, some of which you’re probably familiar with. They include symptoms like:

• Hot flashes
• Night sweats
• Mood changes
• Insomnia
• Low sex drive
• Vaginal dryness

Low hormone levels after menopause can also increase the risk for many health conditions, such as osteoporosis and heart disease.

Our providers may prescribe HRT to help relieve your symptoms during menopause, particularly if you experience hot flashes, as hormone therapy is one of the most effective treatments for menopausal hot flashes, also known as vasomotor symptoms. However, HRT may also help with many other symptoms, such as mood changes, including depressive and anxiety symptoms.

The Link Between Menopause and Anxiety

Many women say they feel more anxious during menopause. In fact, an estimated 23% of women experience anxiety symptoms during menopause. Therefore, it’s no surprise you might be wondering if menopause can cause anxiety or whether there is a connection. Anxiety is a pretty complex condition, so there may be many factors at play. However, hormone and life changes may contribute to feeling anxious during menopause.

Some symptoms of anxiety include:

• Increased heart rate
• Difficulty concentrating
• Irritability
• Excessive worrying
• Restlessness
• Panic attacks
  • Racing heart
  • Sweating
  • Chills
  • Difficulty breathing
  • Shaking
  • Tingly or numb hands
  • Chest pain
  • Dizziness
  • Nausea

Every woman is different, but generally if you have past history of anxiety symptoms, your risk for experiencing anxiety-like symptoms in menopause may be higher. However, there does appear to be a connection between menopause and anxiety, as some studies show that menopausal women are more likely to experience anxiety symptoms and panic attacks compared to pre- or post-menopausal women of the same age.

Some factors that may explain the increased rates of anxiety during menopause include hormone levels and life changes that are common during this time.

Hormone Changes and Low Estrogen May Increase the Risk for Anxiety Symptoms

One reason you may experience anxiety during menopause is due to changing hormone levels. As we mentioned, hormones during menopause typically start to fluctuate, change, and decrease. Low estrogen levels during this time are likely responsible for many menopause symptoms, like hot flashes and mood changes. Many believe estrogen also plays a role in anxiety during menopause. Many women notice their anxiety symptoms get better after beginning HRT with estrogen for their menopause symptoms. In fact, one 2009 study in Gender Medicine journal looked at the relationship between estrogen and behavior linked with anxiety and depression. The researchers found that higher scores for anxiety and depression were associated with lower estrogen levels. Therefore, low estrogen and hormone imbalances during menopause may contribute to anxiety during this stage of life.

Other Reasons for Anxiety During Menopause

However, there may be other factors at play if you’re feeling anxious during menopause. The average age of menopause in the U.S. is 51, which is also an age where many of us experience other life changes as well.

For instance, many women become empty nesters at this time, which can change many family and relationship dynamics. You might be caring for aging parents and dealing with the stressors that come along with it. This is often also a time of high stress in many people’s careers. Some also go through a period where they are re-discovering themselves and may struggle with insecurity. Therefore, many life changes that often happen during the time of menopause can also contribute to mood changes and feelings of anxiety.

Can HRT Help with Anxiety During Menopause?

Since menopausal anxiety may have a hormonal component to it, you might wonder whether HRT can help relieve anxiety symptoms during menopause. Some studies do suggest that estrogen may have some anti-anxiety properties. Of course, you should talk to our providers to find personalized treatment options based on your specific circumstances. However, research from Harvard and Emory University suggests estrogen may play a big role in anxiety.

HRT with Estrogen May Lower Fear Response & Anxiety

According to The Harvard Gazette, recent research shows that estrogen levels may affect how susceptible some women are to anxiety. The article explains that depression and anxiety disorders are about twice as common in women than in men, with times of higher anxiety often linking up with hormone changes, such as puberty, certain periods of the menstrual cycle, pregnancy, and during menopause.

Both studies looked at fear response in relation to estrogen. They found that estrogen may have a calming effect on the fear response, including for women suffering from post-traumatic stress disorder (PTSD). Therefore, there is some evidence that increasing estrogen may reduce anxiety-like symptoms. Researchers are still studying the effects of HRT on anxiety in menopausal women, but many women notice improvements in their mood symptoms after beginning an HRT regimen.

Why Might HRT Help with Anxiety During Menopause?

Estrogen is a sex hormone, so you might be wondering what it has to do with anxiety and why hormone imbalance treatment may help with anxiety symptoms. Scientists are still studying the connection. However, it may be due to estrogen receptors in the brain that can increase the risk for anxiety. For instance, estrogen receptors may affect the hypothalamic-pituitary-adrenal axis, which is basically the relationship between the hypothalamus, pituitary gland, and adrenal gland. The key detail to note here is that this axis has a large impact on your body’s response to stress. Some researchers also believe estrogen receptors in the brain can impact serotonin levels, which may also explain the link between estrogen and anxiety.

Hormone Imbalance Treatment from HerKare

If you’re experiencing menopause symptoms, visit our providers at HerKare for help. We are a women’s health clinic dedicated to empowering women through quality health care. Our team takes a holistic approach to health care and provides treatment solutions personalized to you. If you’re experiencing symptoms of a hormone imbalance, our team may prescribe bioidentical hormone therapy to help alleviate your symptoms. Make an appointment at one of our convenient locations today!