Have a question about women’s health or menopause? Dr. Patricia Yarberry Allen may have the answer. Click here to send in your question to be posted on WVFC.

Question: Breast cancer rates are down, presumably because fewer women are using hormone therapy systemically. Should I stop using my estrogen patch?

Dr. Pat: If a patient has used hormone therapy for more than 18 months, I recommend that she begin vaginal estrogen therapy that is not absorbed into the blood stream, then slowly withdraw from the systemic hormone therapy.

Take a hormone holiday and re-evaluate your need for on-going hormone therapy. Most women find that symptoms of this hormonal transition can be managed with common sense and a plan for dealing with intermittent symptoms. After all, you won’t know if you still have significant reasons for hormone therapy unless you re-evaluate how you feel without this treatment.

The recommendations for hormone therapy were evaluated very thoughtfully by many physicians and scientists after the National Institutes of Health in 2002 cut short a hormone therapy study called the Women’s Health Initiative estrogen-plus-progestin study.

Women taking the combination therapy were at higher risk of breast cancer, stroke, blood clots and heart attacks, according to the study’s findings, and many women stopped taking hormone therapy when the results were made public.

Those recommendations are not affected by this new information. Women who are suffering from menopausal syndrome and feel that their quality of life is really compromised by significant symptoms of temperature instability, night sweats, insomnia, fatigue, mood disturbance or cognitive dysfunction can choose to use the lowest dose of hormone therapy possible — for the shortest period of time possible — to control these symptoms.

It is important to remember that most women in this transition have temperature instability and vaginal dryness. These issues can be controlled with lifestyle change and vaginal estrogen.

Dr. Patricia Yarberry Allen, director of the New York Menopause Center, is a gynecologist affiliated with New York-Presbyterian Hospital and a board certified fellow of the American College of Obstetrics and Gynecology.

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