BY MELISSA JOHNSON, M.D.

Special to the Times

In the U.S., the average life expectancy for a woman is 80 years. that means most American women will be post-menopausal for one-third of their lives, so the effects of their menopause treatment should be carefully considered.

A common treatment for the symptoms of menopause is hormone replacement therapy. In recent years, however, concerns about side effects have risen and non-experts have promoted alternatives, leaving many women asking whether hormone therapy is a safe treatment for the symptoms of menopause or if “bio-identical” hormones are a safer alternative.

Understanding menopause

Menopause begins when a woman’s ovaries stop producing eggs, causing hormone levels to drop and menstrual periods to end. the low estrogen level is often associated with hot flashes and night sweats, as well as difficulty sleeping, forgetfulness and even depression.

For some women, the symptoms can last for years. To treat the symptoms, we need to understand why they occur.

The area of the brain that controls body temperature is strongly influenced by estrogen. a drop in estrogen levels can confuse the brain and cause hot flashes and night sweats. the night sweats can make it difficult to sleep, and that can lead to memory problems and depression.

Boosting estrogen levels to premenopausal levels through replacement therapies can alleviate the hot flashes and night sweats, which can lead to better sleep patterns that correct the rest of the symptoms.

Bio-Identical hormones

In 2002, a national study found that long-term hormone therapy after menopause was associated with a higher risk of heart disease, stroke, breast cancer and blood clots in the legs.

Although the absolute risk is small, the finding concerned many women, leading them to seek alternatives such as bio-identical hormones.

Unfortunately, there is no consistent definition of the term bio-identical hormone. In some cases, it is used in reference to hormones that are molecularly identical to those produced by our bodies. In others, it references the practice of custom compounding hormones to match the individual woman’s “natural” hormone levels.

To date, there has been no medical evidence demonstrating a difference between the effects of bio-identical hormones and non-bio-identical hormones, although many bio-identical hormone proponents claim these treatments are either safer or more effective.

Despite these claims, and those of many celebrity non-experts, the hormones prescribed by your doctor remain the safest. They have been used for years (some for decades), and their short- and long-term effects are carefully scrutinized by the FDA and independent researchers.

For some women, hormone therapy is not recommended at all. there are other medicinal alternatives that work, but lifestyle changes can also help. For example, exercising regularly, avoiding tobacco and maintaining a healthy weight can help minimize the symptoms of menopause.

If you are experiencing menopause symptoms, talk with your doctor. together, you can find a treatment that is right for you.

Melissa Johnson, M.D., is a board certified OB/GYN and is a part of the Sutter East Bay Medical Foundation. she is affiliated with Eden Medical Center.