Menopause Treatment Based On Hormone Replacement

Estrogen Therapy: If a woman has had a hysterectomy (surgery to remove the uterus) or a hysterectomy with bilateral salpingo-oophorectomy (surgery to remove the uterus, fallopian tubes, and ovaries), and she is experiencing menopause symptoms, her doctor may recommend a low dose of estrogen. There are different kinds of estrogen. Most people take a pill or patch every day, but you can also get the hormone in a vaginal ring, gel, or spray.

• Estrogen pill. Pills are the most common way to treat the symptoms of menopause. Conjugated estrogens (Cenestin, Estrace, Estratab, Femtrace, Ogen, and Premarin) or estrogens-bazedoxifene are two of the many types of pills that can be bought (Duavee). Dosing should be done as your doctor tells you. Most estrogen pills are taken only once a day, on an empty stomach. Some have more complicated schedules for when to take them.
• Estrogen patch. The patch is worn on the skin of your stomach. Depending on the dose, some patches need to be changed every few days, while others can be worn for a week. Examples are Alora, Climara, Estraderm, and Vivelle-Dot. There are also patches that contain both estrogen and progestin, like Climara Pro and Combipatch. Menostar has less estrogen than other patches and is only used to lower the risk of osteoporosis. It doesn’t help with any of the other signs of menopause.
• Topical Estrogen. You can also get estrogen into your body through creams, gels, and sprays. Gels like EstroGel and Divigel, creams like Estrasorb, and sprays are some examples (like Evamist). Like patches, this type of estrogen treatment is taken right into the bloodstream through the skin. There are many different ways to use these creams, but they are usually only used once a day. One arm from the wrist to the shoulder is covered with EstroGel. The legs are where Estrasorb is put on. On the arm, Evamist is put on.
• Vaginal estrogen. Vaginal estrogen comes in a cream, vaginal ring, or vaginal estrogen tablets. In general, these treatments are for women who have trouble with dryness, itching, burning, or pain in the vaginal area during sexual activity. There are vaginal tablets (Vagifem), creams (Estrace or Premarin), and rings that can be put in the vaginal canal (Estring or Femring). Schedules for dosing can be different for each product. Most vaginal rings need to be changed every three months. Vaginal tablets are often used every day for two weeks, and then only twice a week after that. Creams can be used every day, a few times a week, or on another schedule.