Although some authorities reduce the calculation of health risk to entering personal data into a Web-based calculator, others advise women to carefully evaluate the assumptions underlying the use of hormones to stem the aging process. Menopausal Gains Clinicians define menopause, natural or induced, as the cessation of menstrual cycles. At menopause, secretion of the ovarian hormones estrogen and progesterone ends. Most geriatricians agree that HRT is effective at alleviating short-term menopausal symptoms such as hot flashes, insomnia, mood swings, and irritability. Although no one knows what causes hot flashes, some believe that they result from the brain's response to changes in the estrogen level.
Hot flashes can lead to insomnia and therefore fatigue, irritability, and poor concentration.
Even though HRT can enhance mood and contribute to a sense of well-being, the actual mechanism by which it does so is not well understood. Underlying the use of HRT to treat perimenopausal symptoms is an assumption that, for most women, menopause represents only a temporary instability in the endocrine system that will eventually give way to a period of restored balance. The onset age for natural menopause is variable, but usually occurs between 40 and 58. The incidence of CVD, the leading specific cause of death for postmenopausal women, increases significantly in the decades following menopause. But the extent to which low estrogen levels increase the risk of CVD in postmenopausal women has not been definitively established.