Exploring MHT in Menopause

Menopausal Hormone Therapy (MHT), previously called Hormone Replacement Therapy (HRT), is used to ease the symptoms caused by dropping levels of estrogen and progesterone during perimenopause, and sometimes into the post-menopause stage. MHT may also help protect against certain long-term health issues linked with these hormonal changes.

Definitions:

• Perimenopause: The transition stage leading to menopause

• Menopause: The point in time marking 12 straight months without a period.

• Post-Menopause: The stage of life after the above point in time when menopause can be declared.

Estrogen

Estrogen is the key ingredient in MHT. It helps reduce hot flashes, night sweats, mood swings, and vaginal dryness, and it also protects bones from osteoporosis.

Progesterone

For people who still have a uterus, mircronised progesterone is added in addition to estrogen to protect the lining of the uterus, lowering the risk of abnormal changes that could lead to cancer. Micronized progesterone is a form of progesterone that is similar to your body’s own progesterone. It’s usually gentler, with fewer side effects. Other types of progesterone (called progestins) are synthetic, and while they still protect the uterus, they may cause more side effects like bloating, skin changes, or mood swings.

• Pills (estrogen- taken orally; progesterone- taken orally or used as a vaginal suppository)

• Gels (Estrogen- rubbed into the skin for body-wide effects)

• Hormonal IUD (Progesterone- placed inside the uterus, it can be kept there for 8 years. The hormone released has a low whole body effect, with a higher concentration locally in the uterus)

• Patches (Estrogen; Estrogen + Progesterone- delivers a steady release through the skin)- not currently available in China.

  
  

Other Systemic MHT options not currently available in China include options such as Implants, Nasal Spray and Vaginal Ring.

• Vaginal Cream or Capsule (Estrogen- used in the vagina, it can help with dryness/atrophy/urinary issues, with little effect on the rest of the body).

• Moderate to severe hot flashes and night sweats

• Vaginal dryness, pain during sex, or repeated urinary infections

• Preventing bone loss and fractures in women at high risk of osteoporosis

• Sleep problems or mood changes linked to low estrogen

  
  

• Effective Symptom Relief: Hot flashes can drop by 80% or more, and vaginal symptoms improve for most women.

• Stronger Bones: Protects against bone loss and lowers fracture risk.

• Heart Health (in some women): Starting MHT before age 60 or within 10 years of menopause may help protect the heart.

• Other Possible Benefits: May slightly lower colon cancer risk; vaginal estrogen is safe and effective for local symptoms.

• Flexible Options: Patches and gels may be safer for women at higher risk of blood clots.

• Breast Cancer: Risk goes up slightly if estrogen and progesterone are used together for more than 3–5 years. Estrogen used without progesterone carries less risk for breast cancer (but increased risk of uterine cancer).

• Blood Clots: Pills raise the risk of clots; patches and gels don’t.

• Heart & Stroke: Risks are increased if MHT is administered more than 10 years after menopause.

• Uterine Cancer: Risk only exists if estrogen is taken without progesterone in people who still have a uterus.

MHT is not suitable for women who have:

• A history of breast or uterine cancer

• Unexplained vaginal bleeding

• A history of blood clots or high clotting risk

• Severe liver disease

• Are pregnant

• Personalized Plans: Treatment should match your age, health, and stage of menopause.

• Use the Lowest Effective Dose: Start low, review regularly.

• Best Combo: Patches or gels with natural progesterone are safest for many women.

• Alternatives: Non-hormonal medicines (like some antidepressants or nerve-pain medicines) or lifestyle changes can also help.

  
  

• MHT is one of the most effective ways to ease menopause symptoms.

• For healthy people under 60 or within 10 years of menopause, short-term use (under 5 years) may bring more benefit than risk.

• Longer-term use needs careful monitoring of breast and heart health.

• Every person’s situation is different- making an informed decision with your healthcare provider is the best way to find balance and relief during this life stage.

Am-Sino International

Women's Health

The Women's Health Center offers personalized, comprehensive health management plans tailored for each woman throughout her life cycle.