Abstract
All FDA-approved systemic estrogen formulations relieve hot flushes. However, menopausal symptoms are not always equivalent to estrogen deficiency. Women in their 40s have varying estradiol levels based upon BMI, ethnicity and other factors. I believe that progesterone has an important role in treating menopausal symptoms and balancing estradiol. Symptoms of high estradiol, such as breast tenderness and enlargement, increased irritability, and frequent awakening (without night sweats), may be best treated with progesterone alone. Administration of estradiol to women with already high (or spiking) estradiol levels may also result in weight gain. While guidelines recommend using hormones for the shortest time possible, I do not believe that women should be encouraged to discontinue them if they feel well and desire to continue.
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Sherif, K. (2013). Hormone Therapy: Individualizing Treatment Based Upon Perimenopausal Symptoms. In: Hormone Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6268-2_8
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DOI: https://doi.org/10.1007/978-1-4614-6268-2_8
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