Menopause, Anxiety & Hormone Replacement Drugs

Mood swings, anxiety, hot flashes and vaginal dryness are among common symptoms that women experience during menopause, which occurs when the ovaries reduce their production of the hormones estrogen and progesterone. Most women enter menopause between ages 45 to 55, or after undergoing a hysterectomy (surgical menopause).

Traditional Treatment

• To treat anxiety and other menopausal symptoms, doctors for decades routinely prescribed hormone replacement therapy (HRT). HRT drugs are primarily forms of estrogen, often in combination with progestins, substances that have an effect similar to progesterone. This therapy was believed to protect older women against heart disease, bone thinning and other serious conditions.

Discovery

• In 2002, as the result of a large clinic trial called the Women's Health Initiative, researchers discovered that hormone therapy, while effective against such menopausal symptoms as anxiety and hot flashes, actually causes a slight increase in the risk of heart disease, breast cancer, stroke and blood clots.

What This Means to You

• Although the risks cause concern in terms of public health, the danger of hormone therapy to an individual is small. In one year, among 10,000 women taking estrogen plus progestin, there might be seven more cases of heart disease, eight more strokes, eight more cases of breast cancer and 18 more blood clots.

Recommendations

• According to the Mayo Clinic, for women experiencing moderate to severe menopausal symptoms such as anxiety, the benefits of short-term hormone therapy outweigh the risks. In addition, taking estrogen for a short term may help protect against osteoporosis, colorectal cancer and, in the early postmenopausal years, heart disease.

Research

• A clinic trial called the Kronos Early Estrogen Prevention Study is under way to study the connection between estrogen use and heart disease in the early postmenopausal years. Results aren't expected for several years.