[MUSIC PLAYING] I'm JoAnn Pinkerton, I'm a Professor of Obstetrics and Gynecology and also the Executive Director for the North American Menopause Society. It's a society that takes care of menopausal women. 

Hormone therapy is a therapy that women who are post-menopausal with hot flashes, night sweats, or elevated risk of bone loss can take to replace what their ovaries used to make. When women go through menopause, about 75% will have some hot flashes-- maybe mild, maybe not too bothersome. About 25% of women will have severe incapacitating hot flashes that stop them in their tracks, soak their beds at night. 

And those women need help. They need some type of medical therapy and hormone therapy is the gold standard. It's the one that really works. It relieves hot flashes. It improves sleep, fewer sleep disruptions, better dream sleep, and it also prevents bone loss and some of the vaginal symptoms that women have. Plus there's a few other benefits. There's fewer cases of diabetes and less heart disease, but only in women who started when they're under age 60 or close to menopause-- within 10 years. 

In 2002, when the Women's Health Initiative study came out, everyone was frightened of hormone therapy because it showed this increased risk of heart disease, and dementia, and blood clots, and stroke. But what we found in the last 15 years is that it really matters age and time for menopause. So women who are under age 60 or within 10 years of menopause are excellent candidates for hormone therapy, particularly if they have symptoms or are at high risk for bone loss. And those women can safely take hormone therapy and we can minimize the risks. Women who are older or further from menopause may actually have more risk from taking the hormone therapy-- more heart disease, more dementia, more strokes, and blood clots. 

So once again, how old you are when you start hormone therapy, how far away from menopause, is really important. So the best candidate for hormone therapy is women who are close to menopause, women who are under age 60 or within 10 years of menopause. They're actually going to have relief of their hot flashes, improvement in sleep, fewer heart disease, and also, fewer cases of diabetes. Women who shouldn't start hormone therapy are women who are older, 60 or 70, or more than 10 or 20 years from menopause. Those are the women that shouldn't start it. 

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