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    Menopause; how long?
    sdoug94661 posted:
    Hi. I am Susan and was diagnosed to be in menopause at 38 when hot flashes began. I was put on an estrogen patch to control the flashes, and I am still on it, even now at the age of 57. If I stop using the patch, the flashes come back, and leave me very uncomfortable. When do these hot flashes stop?!?! How much older to I have to get before they will go away?
    georgiagail responded:
    They may never stop. I have a co-worker nurse who, at age 70, had to be taken off her HRT secondary to breast cancer. Her hot flashes returned once she was taken off the supplemental hormone therapy.

    Jane Harrison Hohner, RN, RNP responded:
    Dear Susan: georgiagail has spoken correctly. According to well done follow up studies, up to 50% of women will have a return of hot flashes following discontinuation. This includes women well past the age of 60. Fortunately, for many women, flashes diminish within 7-10 years after menopause.

    Now that the mantra for hormone therapy (HT) is "the smallest dose for the shortest possible time" more women decide to use HT short term. If one still has intractable flashes despite other treatments a return to HT is considered justified. That is, the risk-benefit ratio is slant toward more benefits.

    Having said all that, if you are using the estrogen patch alone (eg no uterus, so no progesterone) the most recent data analyses suggest no increased risk for breast cancer compared to placebo after seven years use, but some longer term observational studies have found increased risk after 10-15 years of estrogen use. There is a continued risk for increased strokes (more so as women age), and deep vein thromboses (more common during initial use).

    Bottom line, you could choose to have the HT discussion with your GYN every year. You could then base your decision on the most current data and how necessary the transdermal estrogen was for your quality of life.


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