Talking to Your Doctor

If you want to take estrogen therapy (ET) or hormone therapy (HT) for short-term relief of hot flashes or other menopausal symptoms, you and your doctor will need to decide what's best for you.

These guidelines may help you choose:

• Postmenopausal women who have not had a hysterectomy are generally prescribed a therapy that combines estrogen with progestin or natural progesterone. Adding progestin or natural progesterone to estrogen reduces the risk of endometrial cancer, a type of uterine cancer.
• Postmenopausal women who have had a hysterectomy are not at risk for endometrial cancer, and they can use estrogen alone.

Tips on making the choice

• Ask yourself if your symptoms significantly interfere with your ability to function day-to-day. If your answer is "yes," communicate your symptoms clearly to your doctor.
• Have a complete pelvic exam, including a Pap smear. Have a clinical manual breast exam and mammogram.
• Talk to your doctor about having a lab workup including a complete blood count and tests for liver function, blood sugar, cholesterol, triglycerides, calcium and phosphorus levels, TSH for thyroid, and a complete urinalysis.
• Assess your personal and family history of cardiovascular disease, osteoporosis, breast and other cancers.
• Finally, if you do decide to take HT, you should periodically review your status with your doctor. Be alert for signs of trouble, particularly abnormal bleeding, dizziness or severe headaches, and immediately report these to your doctor. They may or may not be due to the HT.

Ask your doctor

Here are some sample questions to ask your doctor:

• Should I take hormones? Why?
• What is my risk factor profile for heart disease, which some studies suggest may be aggravated by HT?
• At what age should I begin?
• What is the best regimen for me? Why?
• How long should I stay on the therapy?
• If breast cancer has occurred in my family, should I consider HT?
• What follow-up tests will I need? How often will I need to take each test?

Check in with your doctor on a regular basis to review your health status and your risk profile, which may change over time.

External Sources National Institutes of Health, Office of Research on Women's Health Society for Women's Health Research

This article was reviewed and updated June 2007.

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