How to limit the risks

Talk with your doctor about these strategies to reduce the risks of hormone therapy:

  • Try a form of hormone therapy that has limited systemic effects. Estrogen and progestin are available in many forms, including pills, skin patches, gels, vaginal creams, and slow-releasing suppositories or rings that you place in your vagina. Low-dose vaginal preparations of estrogen — which come in cream, tablet or ring form — can effectively treat vaginal symptoms while minimizing absorption into the body. Similarly, hormones delivered through skin patches aren't as extensively metabolized in the body and have less potential for unwanted side effects.
  • Minimize the amount of medication you take. Use the lowest effective dose for the shortest amount of time needed to treat symptoms, unless you're younger than age 45 — in that case, you need enough estrogen for protection against long-term health effects of estrogen deficiency. If you have lasting menopausal symptoms that significantly impair your quality of life, your doctor may recommend longer term treatment.
  • Make healthy lifestyle choices. Counter the risks of developing heart disease by making heart-healthy lifestyle choices. Don't smoke or use tobacco products. Get regular physical activity. Eat a healthy diet focusing on fruits, vegetables, whole grains and low-fat protein. Maintain a healthy weight. And get regular health screenings to check your blood pressure and cholesterol levels to detect early signs of heart disease.
  • Seek regular follow-up care. See your health care provider regularly to ensure that the benefits of hormone therapy continue to outweigh the risks, and for cancer screenings such as mammograms and pelvic exams.

A balancing act

Women of all ages should take heart disease seriously. Among U.S. women, 1 in 3 deaths each year is due to heart and blood vessel disease.

Most healthy women who are within five years of menopause can safely take short-term hormone therapy for menopausal symptoms without significantly increasing the risk of heart disease. If you experience classic menopausal symptoms, including intolerable hot flashes, vaginal dryness or insomnia, talk to your doctor about how you can relieve troublesome symptoms without putting your health at risk.

Oct. 25, 2012 See more In-depth