Should I take hormones during menopause to relieve symptoms?

Écrit par Kevin Calatayud
Modifié le : 3 March 2025

Menopause represents a natural phase in a woman's life, often marked by a range of symptoms that can prove difficult to manage, such as hot flushes, night sweats, vaginal dryness and sleep disturbances. The decision whether or not to use hormone therapy to alleviate these symptoms is a complex and highly personal one. Hormone replacement therapy (HRT) or menopausal hormone therapy (MHT) can bring significant relief, but is also associated with certain risks and drawbacks. It's essential to weigh up the benefits and risks associated with HRT, as well as to consider the alternatives available, in order to make an informed choice that best suits your health and quality of life.

What is hormone replacement therapy (HRT)?

Hormone Replacement Therapy (HRT), also known as Menopause Hormone Therapy (MHT), offers a medical solution to the decline in female hormones during menopause. This treatment is essentially based on the supply ofestrogen and, in most cases, progesterone.

Hormones Involved: Estrogen: Estrogen, the key hormone in HRT, has a structure identical to that of naturally produced estrogen. It can be administered in various forms: tablets, gels, sprays or skin patches. – Progesterone: To counter the effects of estrogen on the endometrium and reduce the risk of endometrial cancer, progesterone or its derivatives are included in the treatment. Micronized progesterone, which can be taken orally or vaginally, is often the preferred choice.

Mechanism of action: HRT replaces hormones not produced in sufficient quantities by the ovaries during menopause. Estrogen helps alleviate menopausal symptoms such as hot flushes, vaginal dryness and sleep disorders. It also plays a preventive role against osteoporosis by preserving bone density, and can reduce the risk of cardiovascular disease in some women.

Progesterone, on the other hand, ensures hormonal balance by protecting theendometrium, preventing its excessive thickening, which could increase the risk of endometrial cancer. For women who have had a hysterectomy, progesterone is not necessary.

In short, HRT is a tailor-made treatment designed to mimic the natural hormonal cycle of pre-menopausal women, with hormones whose structure and effects are similar to those naturally produced.

What forms of administration are available ?

Hormone replacement therapy (HRT ) offers several administration options, allowing personalization according to individual needs and preferences. Each method has its own advantages and disadvantages.

Oral administration

Oral tablets, often containing a combination of estrogen and progesterone, or estrogen alone for those who have had a hysterectomy, are a widespread method. Taken daily, they help regulate hormone levels, alleviating menopausal symptoms such as hot flushes and vaginal dryness.

Transdermal administration

Transdermal patches, lotions and sprays offer an alternative, enabling slow, stable hormonal absorption through the skin. This method minimizes the hormonal fluctuations and gastrointestinal side effects often associated with oral tablets. Patches are changed once or twice a week, while lotions and sprays are applied daily.

Administration by vaginal route

Designed to relieve vaginal symptoms such as dryness, burning and pain during intercourse,vaginal hormone therapy includes creams, tablets and vaginal rings. The creams and tablets are used daily or weekly, while the rings provide a continuous release of hormones over a three-month period.

Other forms of administration

Topical estrogen-based gels and sprays, applied directly to the skin, are suitable for those avoiding oral tablets and transdermal patches. Selective estrogen receptor modulators (SERMs) represent another option, targeting osteoporosis or other specific conditions without the systemic effects of estrogen.

In conclusion, the diversity of HRT administration methods enables optimal, personalized selection, aligned with each woman’s specific needs and health profile.

How does it work on menopausal symptoms ?

Hormone replacement therapy (HRT ) is proving to be a particularly effective solution for alleviating menopausal symptoms, offering a significant improvement in quality of life for menopausal women. Let’s explore its action on the most common symptoms:

Symptom Relief

HRT tackles many of the most distressing symptoms of menopause:

Reduced hot flushes and night sweats: HRT works quickly to reduce hot flushes, often in just a few days, by compensating for the lack of hormones. This reduction is particularly significant, with over 90% fewer hot flushes after the start of treatment. (source : https://www.rose-up.fr/magazine/menopause-bouffees-chaleur-hormones/)

The link between progesterone deficiency and hormonal imbalance

Improved sleep quality: Sleep disorders, which are common during menopause, are significantly improved with HRT. The reduction in nocturnal hot flushes and the soothing effect of progesterone promote better quality sleep.
Vaginal dryness and sexual symptoms: HRT helps relieve vaginal dryness and pain during intercourse by rehydrating vaginal tissues and improving lubrication. This significantly enhances sexual health and comfort during intimate relations.
Improved mood and cognitive function: HRT can also improve mood, memory and alertness, contributing to enhanced mental and emotional well-being.

The potential benefits of HRT

Osteoporosis prevention

Hormone replacement therapy (HRT) is recognized for its ability to prevent osteoporosis, a condition marked by reduced bone density and an increased risk of fractures. Estrogen plays an essential role in maintaining bone health, slowing bone mass loss and promoting better bone structure.

Research, including the WHI study, has shown that HRT significantly reduces the risk of osteoporosis-related fractures, particularly of the vertebrae, hip and wrist. This reduction in fracture risk is all the more remarkable in women at the onset of menopause, with a 30% to 40% drop in the risk of femoral and vertebral fractures.

Impact on women’s quality of life: mood, intimate well-being

HRT goes beyond relieving the physical symptoms of menopause, exerting a positive impact on women’s quality of life, including mood and intimate well-being. It improves cognitive function, memory and mental well-being, reducing the mood disorders and mood swings often associated with menopause. The treatment also promotes better sexual health by rehydrating vaginal tissues and increasing lubrication, thereby reducing pain during intercourse and enhancing intimate comfort.

In addition, HRT can improve the condition of skin and hair, strengthening their elasticity and reducing their dryness, thus helping to improve women’s general well-being. In short, HRT provides a multitude of benefits that transcend the simple relief of menopausal symptoms, significantly improving the quality of life of menopausal women.

Disadvantages and risks

Cardiovascular risks

Hormone replacement therapy (HRT) carries significant cardiovascular risks. Recent research, including a study in the British Medical Journal (BMJ), reveals that HRT may increase the risk of cardiovascular disease and thromboembolic events. The dangers of ischemic heart disease, myocardial infarction and stroke are particularly high, especially with specific treatments such as tibolone and oral estrogen-progestin therapy, whether continuous or sequential.

For example, the use of continuous oral estrogen-progestin therapy can increase the risk of ischemic heart disease by 21%, and by 46% with tibolone.

Risks of certain cancers

HRT, which combines estrogen and progesterone, is also linked to an increased risk of certain cancers. Breast cancer is a major concern, with a significantly increased risk in women undergoing this type of treatment over the long term. However, it is important to note that HRT may reduce the risk of uterine cancer, although this benefit may be offset by increased risks of other cancers.

Common side effects

In addition to the more severe risks, HRT can cause a variety of common side effects, such as breast tenderness, bloating, mood changes, increased blood pressure, uterine bleeding and vaginal spotting.

These effects may also include headaches, changes in libido, digestive disorders, changes in the menstrual cycle, and swelling of the hands, feet or legs.

Contraindications

Some women should avoid HRT because of their medical history or specific risk factors. These include women with a personal history of cardiovascular disease, stroke, breast or uterine cancer, or abnormal vaginal bleeding. In addition, women with a family history of these conditions or other problems such as deep vein thrombosis or pulmonary embolism should exercise caution and discuss these risks with their doctor before starting hormone therapy.

What are the natural alternatives to hormone therapy ?

Non-hormonal approaches

For those who prefer to avoid hormone replacement therapy (HRT) or who are unable to use it, many non-hormonal alternatives are proving highly effective in alleviating menopausal symptoms. Here are some of these options:

Cognitive-behavioural therapies (CBT): These therapies have proven effective in reducing hot flushes and other menopausal symptoms, helping to better manage emotional reactions and develop strategies to cope with symptoms.
Hypnosis: Proven to reduce the frequency and intensity of hot flashes, hypnosis is an effective method, even for women diagnosed with breast cancer.
Stress management techniques: Mindfulness and deep breathing techniques can help relieve menopausal symptoms, although relaxation exercises are generally less effective in this context.

Lifestyle adjustments

Simple lifestyle changes can greatly improve quality of life for menopausal women. Here are a few tips:

Balanced diet: A diet rich in fruit, vegetables, whole grains and quality proteins helps maintain a healthy weight and limit the weight gain often associated with menopause. It is also important to consume sufficient calcium and vitamin D to prevent osteoporosis.
Stress management: Yoga, meditation and mindfulness practices can help manage stress and mood swings, improving overall well-being.
Physical exercise: Regular physical activity, such as walking, jogging or muscle-strengthening exercises, helps maintain bone density, reduce the risk of cardiovascular disease and improve sleep quality.

Food supplements and minerals

Certain dietary supplements can also play a beneficial role in managing menopausal symptoms:

[MY] ESSENTIAL SERENITY

My Essentiel Sérénité helps combat physical and mental fatigue, as well as mood swings linked to cycles. Thanks to the combination of three forms of magnesium (bisglycinate, malate and citrate) and three synergistic adaptogenic plants (saffron, griffonia, rhodiola), this natural product naturally stimulates the “happiness” hormones (dopamine and serotonin). What’s more, it’s sugar-free and diabetic-friendly, making it a wise choice for overall well-being during menopause.

[MY] ESSENTIAL FEMININE BALANCE

Our best-selling dietary supplement, specially formulated to support women through menopause and perimenopause. Thanks to its composition enriched with ashwagandha, rosemary, lemon balm and vitamins B9, B12 and D, it helps regulate hormonal variations and alleviate emotional and physical imbalances such as fatigue, digestive discomforts, mental fogginess, anxiety and sleep disorders.

How do I talk to a healthcare professional?

Health check and preliminary analysis

Discussing menopause and its treatment with a healthcare professional begins with a complete health check-up. This includes various tests to assess your overall health and identify any risks associated with menopause:

Gynaecological examination: A thorough examination, including a vaginal smear, cervico-vaginal examination and breast palpation, is essential to detect any abnormalities and confirm menopause.
Mammography: Essential for breast cancer screening, particularly important during the menopause.
Pelvic ultrasound: Inspects the uterus, ovaries and fallopian tubes for abnormalities.
Bone densitometry: Measures bone mineral density to assess the risk of osteoporosis, a risk that increases during menopause.
Lipid profile: Cholesterol, blood sugar and triglyceride monitoring is recommended to monitor cardiovascular risk.

Questions to ask your doctor

Preparing a list of questions for your doctor is essential for obtaining clear information and making informed decisions:

Symptoms and diagnoses: Clarify whether your symptoms are related to menopause and whether you are in perimenopause or menopause.
Hormone replacement therapy: Discuss the possibility of hormone replacement therapy, weighing up the potential benefits and risks.
Other treatments: Find out about non-hormonal alternatives adapted to your symptoms, such as cognitive-behavioral therapies or dietary supplements.
Impact on mental health: Discuss the effects of menopause on your mental well-being and ask for advice on managing mood fluctuations.
Preventive examinations: Find out about the preventive examinations needed to detect precancerous diseases and cancer.

The importance of regular follow-up

Regular follow-up with a healthcare professional is vital to effectively manage menopausal symptoms and prevent complications:

Gynecological follow-up: To detect abnormalities early and maintain good genital and breast health.
Disease prevention: Helps prevent or detect cardiovascular disease, osteoporosis and cancer at an early stage.
Treatment adjustments: Ensures treatment adjustments based on the evolution of your symptoms and overall health, for optimal management.

In short, open communication and regular follow-up are essential to navigating the menopause period in an informed and safe way.

Conclusion

Menopause, a natural stage in every woman’s life, can sometimes seem confusing and challenging. Nevertheless, it’s important to understand that this period of transition can also mark a renewal, offering the opportunity to navigate towards a new phase of life with confidence and well-being. Adopting an appropriate lifestyle, combined with dietary adjustments and the use of supplements, can play a significant role in managing symptoms.

Talking openly with your doctor, through regular check-ups, helps build a dialogue based on trust and information. This is essential for evaluating the treatment options available, whether hormonal, non-invasive or natural alternatives. Considering the potential risks and benefits of each option, based on your medical history and personal preferences, is fundamental to maintaining an optimal quality of life.

Don’t hesitate to consider natural treatments. Menopause shouldn’t be seen as a period of decline, but rather as a chance to redefine your well-being and live through this transition in the healthiest, most positive way possible.