Writer Ellen Margulies

By Ellen Margulies

Just when you think you’ve pretty much explored all the joys of womanhood – you know, 40 years of menstruation, wearing heels all day and, of course, childbirth – along comes menopause. Hot flashes. Mood swings. Night sweats. Plummeting sex drive. Mouth sores. Yes, mouth sores (I found out about those when I was experiencing a bout of painful unexplained bumps on my tongue, which turn out to be one of the many unheralded bonuses of peri-menopause). And don’t forget the unwanted facial hair. I have a better beard than most 16-year-old boys.

Of course, being modern 21st-century women, we have choices. We can opt for hormone replacement therapy, which allows us to ingest or adhere doses of estrogen and progestin. Or we can, as a doctor recently joked to my friend H., “bite down on a leather strap.”


Hormone replacement therapy, or HRT, can do some wondrous things. Quell the night sweats and hot flashes, for starters. Even out those mood swings. It can keep your libido up, maintain your skin’s elasticity and reduce the need for a morning shave. Seems like such a no-brainer, except of course it’s just not that simple. There are some serious side effects that every woman has to consider before deciding whether to opt in.

Everyone has surely heard about the increased risk of cancer, more specifically uterine, breast and ovarian. According to WebMD, there’s also a greater chance for blood clots and heart disease, which can kill you; stroke, which can paralyze you; and dementia, which can make you even more absent-minded than you already are, although that doesn’t even seem possible some days. Oh, there’s also the possibility of gallstones, nausea, vaginal bleeding, dizziness, weight gain, breast tenderness, headaches, and, ironically, increased anxiety and moodiness.

Suddenly, it seems like a no-brainer in the opposite direction. It really isn’t, though. Obviously, not everyone has problems. Some women benefit tremendously from HRT. I have to admit that its potential to alleviate the more aggravating symptoms of impending menopause is really very tempting to me. But then I remember that my mother had breast cancer (and is doing great after several surgeries, including a double-mastectomy). And having that personal family history really frightens me, because my risk is already elevated.


Truthfully, as I find myself increasingly immersed in the symptoms of menopause, even though it hasn’t fully hit yet, I haven’t really made up my mind what I’m going to do. I’ve had a conversation with my gyno, who is a menopause specialist, but it wasn’t really all that affirming. I guess I’d half-hoped he would simply tell me what to do, but he didn’t. And couldn’t, truthfully. He gave me some literature about the risks of HRT, but it didn’t do much to make up my mind either way. He did caution me that so-called “natural” HRT carries with it the same risks as estrogen and progestin, so you have to be careful about finding alternatives. I’ve tried some over-the-counter remedies like Estroven with some success; it’s really just a multi-vitamin, but I suppose my easily-influenced mind was won over by their clever marketing. I keep buying it, at any rate.

Knowing me, I’ll probably stall the decision for so long that I will have effectively made a decision against it. In the meantime, I’m wearing less and less to sleep in and keeping those regular appointments for a lip and chin wax. Guess I better find myself a good leather strap.

Q: What is hormone replacement therapy?

Expert Jenny Brunette Verner answers your questions.