Once we start a woman on hormone therapy for menopausal symptoms it’s sometimes challenging to figure out how to stop or even when to stop!
At first there were no studies to guide us. And then it just seemed sensible to taper, so that’s what women just did on their own, or their docs told them to do that. For many women it is easier to come off a very low dose than a high dose, so if you are on a low dose tapering off on your own is definitely easier. If you are also on other medicines, like herbals, or anti-depressive medications you may have fewer menopausal symptoms when you stop, making it easier to quit.
How to manage your heath without hormones should be discussed ahead of time: questions to ask include what will happen to your sex drive, your weight, your mental clarity, your moods, your bones, and your heart.
Fortunately, women of today are on about a fourth of the dosage women of the seventies were on, so stopping hormone therapy is easier than it was in the past. A relatively recent study in Menopause by Dr. Lindh-Astrand et al has pointed out that after a year in their study about 50% of the former hormone users were right back on. Of course we recommend that you do this with consultation.
Former users who are too symptomatic just jump right back on. In fact almost 30% of their group were back on in a week!They only tested a 4 week taper, and to no surprise, it was really more related to whether you had some symptoms to begin with that gave a greater likelihood of success rather than just taper or cold turkey. And now that we have studies that say you have less breast cancer and less heart disease if you are on conjugated equine estrogen (with no progesterone) in women who have had a hysterectomy and have used the estrogen up to ten years, perhaps stopping is not the best for those women.
So, still see your gyno and figure out the best game plan for you. But if you have reasons to stay on for bone health, heart health, vaginal health, libido, or still have hot flash symptoms, odds of getting off hormones this year: slim.