Menopause and Hot Flashes

How long can hormone therapy be used?

Hot flashes are a common vasomotor symptom during menopause that occurs when quick bursts of body heat cause sweating for up to 5 minutes. It is a fleeting symptom that can persist for ten or more years! Hormone therapy (HT) is an effective treatment for hot flashes. While HT is not recommended to prevent the onset of hot flashes, it can significantly improve sleep and quality of life for those who are impacted by vasomotor symptoms during the menopause transition. 

All medications have risks, however for healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks.

But when is the best time to stop taking HT for hot flashes? 

Many women try to stop HT after 4-5 years to re-assess whether the medication is still needed. Evidence suggests a potential rare risk of breast cancer in women older than 60-65 who take HT longer than 4-5 years. Some women may choose to switch to lower dosages via alternative administrations of HT, such as a transdermal administration, to reduce the small increased risk of stroke or blood clots associated with the pill. Hot flashes may or may not return after stopping HT. Slowly reducing the dosage over several months or years may lessen the chance that hot flashes will return.

Women beyond age 65 can continue HT if they determine with their healthcare provider that it is their best choice to manage ongoing hot flashes that are negatively impacting their quality of life. Women taking HT for 4-5 years should consider discontinuing if there is no longer a need. If there is still a benefit, switching to the lowest dose of HT that affords adequate relief is recommended.  Determining the right time to stop HT, or adjust to a lower dose, is a personal decision for each woman in consultation with her healthcare provider based on individual risks and benefits.