If you’re a woman over age 35, you may have begun experiencing unusual symptoms of fatigue on a regular basis that have you concerned, such as going through your day feeling out of sorts and more tired or irritable than usual.

This may even be accompanied by hot fl ashes, night sweats, lack of decent sleep, migraines, moodiness, a loss of excitement for anything, overall exhaustion and a general feeling as though the life is just being sucked out of you.

If this is you and especially if you are closer to age 50, it’s likely that you are experiencing pre-menopausal symptoms or menopause.

This can be confi rmed by a trip to your doctor, though it may also result in a quick prescription for antidepressants. Before you start medication, though, consider some options.

Hormone replacement therapy is often used by doctors to actually replace hormones that have decreased as a woman ages.

The therapy is also sometimes known as postmenopausal hormone therapy or postmenopausal hormones.

The therapy doesn’t reverse the process, but it can re-establish hormonal balance and make the menopausal transition much easier.

While the symptoms of menopause tend to fade away at some point whether or not they are treated, “The therapy is very successful at helping patients regain natural hormonal balance so the symptoms decrease sooner, and the patient can begin to feel like herself again,” said Dr. James Barrow, assistant professor of OB/GYN at LSU Health Shreveport.

“A woman is born with a set number of eggs in her ovaries,” he explains. “Once these eggs reach a critical level, which is about 1,000, the ovaries stop producing estrogen and progesterone.

“This is when a woman gets into the pre-menopausal period. The average age for this to occur is 51 years, and they may have symptoms of menopause such as night sweats, hot fl ashes and trouble sleeping.

“Some patients report having many hot flashes at night, and when they wake up, the bed is drenched.

“It’s when these symptoms begin occurring that hormone replacement therapy can be used.”

There are two types of therapy available specifi cally for women: estrogen alone or estrogen plus progesterone, which is also called estrogen progestin therapy or combined therapy.

“When you go to your doctor to ask about the therapy, the fi rst thing your doctor will want to know is if you’ve had a hysterectomy,” Barrow explains. “If you have, then you have to use the estrogen alone.

“For women who still have a uterus, they must use the combined therapy of estrogen plus progesterone. The reason is that if you give someone estrogen by itself while they still have a uterus, you increase the risk of endometrial cancer.”

In the U.S., about 600,000 hysterectomies are performed annually, and by age 60, about 37 percent of all women have undergone the procedure. About 80 percent of women experience menopausal symptoms of hot fl ashes, and about 20 percent seek hormone replacement therapy.

Barrow said the therapy is very common and the risks are extremely small, though anyone considering using it should consult with their OB/GYN about the side effects.

According to a study by the Women’s Health Initiative, the main risk of either therapy is an increased risk of stroke and blood clots. However, it’s only while the therapy is underway. Combined therapy specifi cally can increase the risk of breast cancer and heart disease.

Something else to ask your doctor about are the two divisions of hormone replacement therapy: bioidentical and synthetic.

Dr. Christiane Northrup, author of “The Wisdom of Menopause,” explains in her book that bioidentical therapy means it matches exactly the molecular structure of the hormone that your own body produces.

“It’s a hormone from Mother Nature,” she writes. “So if you get the raw material from soybeans and yams, which they do, and then you convert it into something that matches your own body’s hormone exactly, that is a bioidentical hormone.

“Synthetic hormones are made from horse urine and are natural for a horse. But they’re synthetic for a human body. They are often added to a synthetic progestin, which doesn’t match your body’s natural progesterone. It has completely different effects, but many women do well on these.”

Barrow said there are two ways to administer the therapy, topically or systemically, via a vaginal cream or pills, and that there’s no time period for the therapy to be completed.

“Current recommendations are for women to stay on the therapy until the symptoms diminish,” he said, “which can be anywhere from a few months to a year or more.

“The best thing to do is talk with your OB/ GYN about the therapy and what’s right for you. At LSU Health Center, we are able to offer very short appointment times as little as two weeks.”

– Eric Lincoln

DID YOU KNOW?

Hormone replacement therapy is often used by doctors to actually replace hormones that have decreased as a woman ages. The therapy is also sometimes known as postmenopausal hormone therapy or postmenopausal hormones