Leaflet for Women

World Menopause Day 2024

Menopause and Menopause Hormone Therapy

he International Menopause Society – founder of World Menopause Day (celebrated every year on 18th October) – brings together the world’s leading experts on menopause and midlife women’s health to improve the experience of women globally.

World Menopause Day 2024

Though menopause and menopause hormone therapy are wellunderstood in some parts of the world, they still receive little attention or remain controversial in others. This is the reason why we chose it as the official theme of this year’s World Menopause Day. Our goal is to ensure that we empower you with evidencebased resources to make fully informed choices.

The 5 Ws of Menopause Hormone Therapy (MHT) A Practical Guide

In this leaflet, you will learn about the 5Ws, “Who, What, When, Why and Where” , of MHT to guide you no matter where you are in the world.

WHO IS MHT FOR?

Your healthcare professional (e.g. doctor, nurse, etc.) may offer you MHT if you are dealing with symptoms that affect your daily life. It can help with:

Hot flushes: Sudden heat sensations in the face and upper body, often followed by sweating.
Night sweats: Waking up drenched in sweat, which can disrupt sleep.
Vaginal dryness: Making sex uncomfortable and even painful, increasing the risk of urinary infections.
Urinary symptoms: Needing to go to the bathroom more frequently or urgently.

MHT is also recommended for:

Premature Ovarian Insufficiency: When menopause happens before the age of 40. Even if there are no symptoms, MHT helps protect against conditions like osteoporosis (weak bones), heart disease, and brain issues.
Early Menopause: If menopause occurs before the age of 45, MHT can be offered even if there are no symptoms because it protects long-term health.

Who might NOT need MHT?

Women who go through menopause at the natural age (after 45) and have no bothersome symptoms usually don’t need MHT. Some people believe MHT is a “fountain of youth” , but there’s little scientific evidence for that. It’s important to remember MHT is not recommended solely to prevent aging, memory loss, or dementia.

Women with existing medical conditions

Women with certain medical histories such as breast cancer and blood clots should talk to their healthcare professional about whether MHT is safe for them. Deciding to use MHT is a personal choice and should involve discussions about the benefits and risks with a healthcare professional who knows your health history

WHAT IS MHT?

MHT supplements the hormones your body stops making after menopause. These hormones, particularly estrogen and progesterone, are crucial for managing menopause symptoms and protecting your health.

Estrogen: The main hormone used in MHT. It helps reduce hot flushes, night sweats, and vaginal dryness.
Progesterone: This is given to women who still have a uterus (womb). It helps protect the womb lining from growing too much when taking estrogen.

Types of MHT

MHT can be taken in different forms which include:

Tablets: Easy to take, but may have higher risks of blood clots.
Patches, sprays, and gels: Absorbed through the skin and are often safer for women with certain risk factors.
Vaginal creams, gels, tablets and rings: Often used for vaginal symptoms like dryness or discomfort during sex.

It’s important to note that custom-compounded bioidentical hormone therapy is NOT recommended because it lacks regulation, rigorous safety and efficacy testing, batch standardization, and purity measures.It’s important to note that custom-compounded bioidentical hormone therapy is NOT recommended because it lacks regulation, rigorous safety and efficacy testing, batch
standardization, and purity measures.

Some people believe MHT is a “fountain of youth” , but there’s little scientific evidence for that. It’s important to remember MHT is not recommended solely to prevent aging, memory loss, or dementia.

WHEN SHOULD MHT BE STARTED AND STOPPED?

When to Start

Symptom relief: MHT can be started when menopause symptoms like hot flushes and night sweats begin to interfere with daily life.
Early menopause and Premature Ovarian Insufficiency: For women with early menopause or Premature Ovarian Insufficiency, starting MHT as soon as possible is recommended to reduce the risk of long-term health problems like bone thinning (osteoporosis) and heart disease.

When to Stop

There is no set rule for when to stop MHT. Some women use it for only a few years, while others may need it longer.
It’s important to regularly check with your healthcare professional to see if continuing MHT is the right choice for you.

Long-term use

There is no strict limit on how long you can use MHT, but long-term use may carry certain small risks, such as increased chances of breast cancer or blood clots. Your healthcare professional will help weigh these risks against the benefits based on your personal health history, and you should have at least an annual discussion of this risk : benefit balance.

Perimenopause and Postmenopause

Perimenopause: The time leading up to menopause when periods become irregular. MHT can sometimes be used during this time but may cause some side effects, like spotting or breast tenderness.
Postmenopause: After menopause, MHT can still help with symptoms but should be reviewed regularly with a healthcare professional to ensure it’s still needed.

WHY IS MHT IMPORTANT?

Why consider MHT?

MHT helps women manage the challenging symptoms of menopause and protects against conditions that become more common after menopause, such as:

Hot flushes and night sweats: The most common and often disruptive symptoms of menopause.
Vaginal symptoms: Such as dryness or discomfort, which can affect sexual health and quality of life
Bone health: MHT helps protect against osteoporosis, a condition that weakens bones and can lead to fractures.
Heart health: For some women, MHT may lower the risk of heart disease, especially when started close to the time of the menopause transition.

What are the risks?

While MHT offers many benefits, there are some small risks:

Breast cancer: There is a slight increase in risk, especially with long-term use.
Blood clots: This risk is higher with certain forms of MHT, like tablets.
Stroke: Older women or those with certain health conditions may be at higher risk.

It’s important to have a personalized discussion with your healthcare professional to understand how these risks apply to you.

WHERE CAN YOU GET MHT?

Accessing MHT

MHT is available through your healthcare professional, but access may depend on where you live. In some areas, especially in lowincome regions, access to MHT can be limited. If you’re having trouble finding MHT or want to explore your options, consult a healthcare professional who understands menopause management.

How to Find Information

More detailed information on The 5 Ws of Menopause Hormone Therapy (MHT) is available via this link and QR code below

It’s important to follow advice from trusted menopause experts and your healthcare professional rather than relying on unvalidated online sources that may lack qualifications and/or regulation.

The International Menopause Society (IMS) and its information resource for women, Menopause Info, provides evidence-based information from credible sources. On the IMS website, you can also search for a menopause society in your country/region which can support you to find trusted information and healthcare professionals in your area.

Your healthcare professional can help guide you to trustworthy information and resources

Final Tips

Talk to your healthcare professional: Menopause is a natural stage of life, but if your symptoms are affecting your quality of life, it’s important to discuss treatment options with a healthcare professional.
Stay informed: Rely on information from trusted sources. Be sure you understand both the benefits and risks of MHT so you can make a choice that fits your health needs.
Don’t suffer in silence: Many women experience relief from MHT, but other options are available if it’s not right for you.