Why the Controversy over the Use of Hormone Replacement Therapy for Menopause?

Learn what menopause is and why there’s such a hoopla over HRT therapy.

Sanaz Majd, MD

When estrogen levels drop during menopause, women just don’t feel well.  That is a fact.  I have never had a woman come into my office and tell me that she feels so much better now that she is experiencing menopause.  Never.  There may be a VERY select few who don’t feel very different, but no one ever tells me that sense of well-being actually improves.

What is Menopause?

I very often have women who come into my office to ask me for a blood test to see whether or not they are in menopause.  However, a blood test is not often diagnostic and can often be misleading.  In fact, the technical definition of menopause is one year without having a menstrual period.  That’s it.  That’s how you’ll know when you are officially menopausal.  Average age of menopause in the U.S. is 51--that means some women experience it before and some after.

In the several years before menopause, and up to ten years prior, women can start to sense the changes of what is called “perimenopause,” which can often continue to heighten until actual menopause.  During perimenopause, estrogen levels gradually decline.  And with the decline of estrogen, women eventually stop producing eggs and ovulating.  That is a normal physiologic process that is just a part of life. 

What are the Symptoms of Menopause?

When estrogen levels drop, our sense of well-being often drops too. Low estrogen can make us feel pretty crummy.  Here are some of the most common symptoms that women experience, even beginning as early as the late 30’s to early 40’s:

  • Hot flashes

  • Changes in mood

  • Depression

  • Fatigue

  • Vaginal dryness

  • Pain with intercourse

  • Infrequent or lighter menstrual periods


About the Author

Sanaz Majd, MD

Dr. Sanaz Majd, a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. She sees everything from pediatrics to geriatrics, but her special interests are women's health and patient education. She also loves to teach, and has been doing so since her college days.

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