Facts: Hormonal treatments for menopausal problems
Estrogen: The female sex hormone given for menopausal symptoms.
Progestagen: A synthetic corpus luteum hormone that is often given in combination with estrogen for severe menopausal symptoms. Progestagen is slightly different from the body’s own corpus luteum hormone.
Bioidentical progesterone: A corpus luteum hormone that, unlike progestagen, looks identical to the body’s own. Has become a popular option as part of treatment for menopausal symptoms. Bioidentical progesterone has both a calming effect and can provide better sleep if you take the tablet in the evening.
Source: Karolinska University Hospital
Menopausal symptoms affect 75 percent of all women between the ages of 45 and 60. 30 percent suffer from such serious problems that they want treatment. Currently, the standard treatment for menopausal symptoms consists of a combination of estrogen and progestin. In recent years, it has become more common to receive treatment with estrogen in combination with bioidentical progesterone, which is a type of corpus luteum hormone that is similar to the body’s own hormone.
A large study that is now being carried out at Karolinska University Hospital will investigate the difference between the treatments, both in terms of well-being and cancer risk.
— It is very exciting that I get to be part of this. The study is also in international demand, says Angelica Lindén Hirschberg, professor of gynecology at the Karolinska Institute and chief physician at the Karolinska University Hospital.
She is leading the study and one of the aims is to find out if there are treatments that are better than others.
— We want to find out how big a difference there is between different treatments, because when we get answers to those questions, we can also tailor treatments and find different options for different women. Because it doesn’t have to be the case that one treatment is the best for everyone.
30 percent of all women aged 45-60 have such severe problems during menopause that they want treatment. Stock image. Controversial with treatment
For most of the 2000s, going on hormone therapy to relieve menopausal symptoms has been controversial, mainly because of the cancer risk.
What we already know is that when estrogen was given alone, the risk of uterine cancer increased, and when estrogen was given in combination with progestin, which is today’s standard treatment, the risk of breast cancer increased instead.
— We know that hormone treatment is effective against menopause symptoms, but it is precisely the safety that we need reliable data on. We hope to gain knowledge about that now.
Angelica Lindén Hirschberg says that she sees a trend around more people starting to talk about the problems that can arise in menopause and that there is an increased discussion.
— It is very positive. I usually say that we have had a lost generation where many have been ashamed of their symptoms.
“Important to seek help”
The most common complaints that women experience in menopause are hot flashes, sweating and sleep problems. When the problems negatively affect the quality of life, it is important to seek help, says Angelica Lindén Hirschberg.
— The advantages of treatment outweigh the disadvantages if you start it close to the last period. We do not recommend that you go on treatment for the rest of your life. For most people, the symptoms usually disappear within five years.
— It is very important that you seek help and that we talk about it because it is a tough period in life. When I lecture about menopause, I usually say that the best thing is that it passes, but it’s a struggle when you’re in the middle of it, says Angelica Lindén Hirschberg.
The study is a so-called double-blind study, which means that the patients are randomized to a treatment with either estrogen and progestin or estrogen and bioidentical progesterone. Neither doctors nor patients know what treatment is being given.
The study will require data from 400 women aged 45 to 60 with clear menopausal symptoms, and the results are expected to be presented in five years.