Managing Hormone Therapy During Menopause: Key Questions and Considerations

Hormone Replacement Therapy for Menopause

Currently, I have just turned 50 years old and have not yet reached menopause, but my blood test shows an estrogen E2 level of only 28.
The doctor said I have entered menopause.
Due to severe long-term insomnia, I am experiencing anxiety and high blood pressure.
I have started taking Ismogen 0.626 mg (estrogen) and Fuanmon 200 mg (natural progesterone).
On the 21st day of the first month of use, my period came, and I stopped taking the hormones.
The flow was similar to when I was 40 years old and lasted about five days.
After that, I resumed taking the hormones, and again, on the 21st day, my period came, but the flow was a bit heavier.

1.
Is it possible that the medications I am taking are not suitable for me?
2.
Should the dosage of the medications be adjusted?
3.
Should I continue taking the medications when my period starts? Do I need to return for a follow-up appointment since the doctor has already prescribed a continuous three-month prescription?

Hu Li, 50~59 year old female. Ask Date: 2021/01/03

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you can continue taking the medication and gradually adjust to it.
Please return for a follow-up appointment after finishing the medication.
Wishing you good health.

Reply Date: 2021/01/03

More Info

Managing hormone therapy during menopause can be a complex process, especially when considering individual symptoms, hormone levels, and the potential side effects of treatment. Given your situation, where you are experiencing significant symptoms such as severe insomnia, anxiety, and high blood pressure, it is crucial to approach hormone therapy with careful consideration and regular monitoring.

1. Suitability of Medication: The medications you are currently taking, Estradiol (伊使蒙) and natural progesterone (婦安蒙), are commonly prescribed for managing menopausal symptoms. However, the fact that you experienced a menstrual cycle after starting the therapy suggests that your body may still be responding to hormonal fluctuations. This could indicate that the dosage or the specific combination of hormones may not be optimal for you. It's essential to discuss with your healthcare provider whether these medications are appropriate given your current hormonal status and symptoms.

2. Adjustment of Dosage: Hormone therapy often requires adjustments based on how the patient responds. If you are experiencing heavy bleeding or irregular cycles, it may be a sign that the dosage of either the estrogen or progesterone is too high. Your healthcare provider may consider adjusting the dosage or switching to a different formulation. Regular follow-ups and blood tests can help determine the right balance for your hormone levels.

3. Timing of Medication: The timing of when to take hormone therapy can also influence its effectiveness. Generally, if you are on a continuous regimen, you would continue taking the medication even if you experience a menstrual cycle. However, if you are on a cyclic regimen, your doctor may advise you to stop taking estrogen during the progesterone phase. It is essential to clarify this with your healthcare provider, as they can provide guidance based on your specific treatment plan and symptoms.

4. Follow-Up Appointments: Since your doctor has prescribed a three-month supply of your medications, it is advisable to schedule a follow-up appointment before the end of this period. This will allow your doctor to assess how well the therapy is working, evaluate any side effects you may be experiencing, and make necessary adjustments. Regular monitoring is particularly important in the first few months of hormone therapy to ensure that it is effective and to minimize risks.

In addition to medication, consider discussing lifestyle changes that can help manage your symptoms. These may include:
- Dietary Adjustments: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help stabilize hormone levels and improve overall health.

- Exercise: Regular physical activity can help reduce anxiety, improve sleep quality, and manage weight, which is particularly important for cardiovascular health.

- Stress Management: Techniques such as mindfulness, yoga, or cognitive-behavioral therapy can be beneficial in managing anxiety and improving sleep.

Lastly, it’s important to remember that every woman’s experience with menopause is unique. What works for one person may not work for another, and finding the right balance may take time. Open communication with your healthcare provider is key to navigating this transition effectively.

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