Menopause: A Holistic Approach to Health and Aesthetics

Berit Lavik
Dec 9, 2025
6 min read

WHAT IS MENOPAUSE?

Menopause is a completely normal physiological process. For some women, it occurs without any discomfort, while for others it can cause significant symptoms and reduced quality of life.

A woman enters menopause because, as she ages, her body runs out of the many thousands of eggs she was born with. When the ovaries stop maturing eggs, the production of the female hormone estrogen decreases. This usually happens between the ages of 45 and 55, with an average age of 51.6 years.

The first signs of menopause are often irregular and heavy menstrual periods. You know you have entered menopause when you have had your last menstrual period.

It is possible to measure a hormone that can indicate whether menopause is approaching. However, you can still be entering menopause even if it cannot be detected in a blood test.

SYMPTOMS AND DISCOMFORTS

About 20% of women experience no symptoms related to menopause.

60% have moderate symptoms, while 20% experience severe, sometimes unbearable symptoms.

Hot flashes are a typical problem during menopause. They can appear suddenly and are often accompanied by a sensation of heat, sweating, and redness in the face, neck, chest, and back. An episode usually lasts only a few minutes, but for women who experience nighttime hot flashes, sleep quality can be significantly affected.

Osteoporosis occurs because bone mass is no longer maintained by estrogen. Bone mass decreases by about 2% per year. Approximately 40% of women over 70 experience bone fractures, typically in the wrist or hip.

Urinary urgency and incontinence (“I have to go right now!”) and an increased risk of urinary tract infections can occur because the lining of the urethra and bladder becomes thinner and more porous.

Mood and mental health are also affected. Hormonal imbalance causes physical and psychological changes that can be difficult to cope with. The vaginal lining becomes thinner, less flexible, and drier, which can cause burning and pain during intercourse.

Skin and hair changes: The skin loses elasticity as collagen levels decrease. Hair may lose its shine and become thinner.

There is also an increased risk of cardiovascular disease, as elevated cholesterol levels can lead to atherosclerosis and high blood pressure. Muscle and joint pain often become more pronounced with decreased estrogen.

HORMONE THERAPY DURING MENOPAUSE

Menopausal symptoms can be treated medically with hormones. The most commonly used treatments are patches, gels, or sprays containing estrogen. Estrogen helps reduce hot flashes, improves sleep, and supports the condition of hair, skin, and joints.

If you take estrogen, it should be combined with progestogen, which protects the uterus from polyps, overgrowth of the uterine lining, and uterine cancer.

Estrogen also helps prevent osteoporosis, certain forms of cardiovascular disease, and colon cancer. By the age of 55, the risk of cardiovascular disease in women is about 66%. Osteoporosis affects one in three women over 50 and can lead to fractures in the vertebrae, wrists, and hip.

The combination of estrogen and progestogen carries a slightly increased risk of breast cancer, which is a concern for many women. The lifetime risk of breast cancer in Denmark is about 10% for women who do not use hormones.

If 1,000 women use estrogen and progestogen for 10 years, there will be 19 additional cases of breast cancer. This applies only when both hormones are used—i.e., in women who have a uterus.

Women without a uterus can take estrogen-only therapy without an increased risk of breast cancer. Women with a hormonal IUD can also be treated with estrogen-only therapy. Bioidentical progestogen preparations are also now available, which do not carry the same breast cancer risk.

WHICH HORMONE THERAPY IS BEST?

Hormone therapy is always an individual assessment. It depends on your overall health, symptoms, and the benefits and risks of hormone therapy.

If you are experiencing symptoms, it is best to start hormone therapy as early as possible. You do not need to wait until your menstruation has stopped. The timing always depends on your symptoms and how you feel.

Remember that local vaginal hormone therapy does not affect general menopausal symptoms; it works locally only.

LOKALHORMON I SKEDEN

Local hormone therapy is available as suppositories or rings and also contains estrogen. This treatment is typically used for vaginal dryness and irritation. If you have incontinence, local hormone therapy can also be effective, as it helps normalize the cells in the vagina and urinary tract.

Additionally, the normal vaginal bacterial flora and pH (around 4.5) are restored. This makes the cells better able to resist irritation and infection. Optimal effects usually appear after a few months of use, so patience is important.

There is no risk of cancer or blood clots with low-dose, locally acting estrogen, and side effects are very rare. In uncommon cases, temporary irritation or discharge may occur.

HAVE YOU HAD BREAST CANCER?

Women who have been treated for hormone-sensitive breast cancer can still use low-dose vaginal hormone therapy. Your oncologist at the hospital would have informed you about this.

Of course, the final decision is yours. If you are uncertain, you can, for example, try vaginal products containing hyaluronic acid instead.

RESEARCH

Danish research, also known as the DOPS study, shows that women who started low-dose hormone therapy immediately around menopause—i.e., before age 55—halved their risk of cardiovascular disease. They did not have an increased risk of breast cancer or other cancers.

This contrasts with the earlier “Million Women Study”, where the average age of participants was 63. That study found an increased risk of breast cancer and cardiovascular complications, likely due to the naturally higher risk of disease with increasing age.

The Danish DOPS study found 50% fewer cardiovascular events among women on hormone therapy compared with the control group. Furthermore, there was no increased risk of breast or other cancers among women using low-dose hormone therapy. The study included 1,000 women over a ten-year period with six years of follow-up, making it the longest-running trial of its kind.

In 2019, a new analysis of 108,647 women with breast cancer was published, with 60% of the participants from the Million Women Study. This study suggests that breast cancer risk depends primarily on progestogen, i.e., the progestogen component of hormone therapy (not estrogen), especially in lean women with a BMI under 30.

The risk of breast cancer after one year of treatment was very small but increased with longer use. Translated to Danish conditions, for women using estrogen plus daily progestogen, the breast cancer risk is likely around 11–12%, compared with about 10% in women who do not use hormones. The risk with estrogen-only therapy was not significantly increased.

Approximately 4,500 new cases of breast cancer are diagnosed annually in Denmark. Western lifestyle factors also significantly influence breast cancer risk. Breast cancer occurs in all age groups: about 20% in women under 50, 50% in women 50–70, and the remaining 30% in women over 70.

Based on the 2019 analysis, the Danish Health Authority has stated:

"The study does not change the current recommendations for the use of hormone therapy. It is important that doctors and patients weigh the risks of different types of hormone therapy against the benefits."

BENEFITS OF HORMONE THERAPY

Reduces hot flashes and night sweats
Reduces joint pain
Reduces vaginal dryness, irritated bladder, weak pelvic floor, and prolapsed bladder
Reduces sexual problems
Prevents osteoporosis
Prevents cardiovascular disease
Slightly lower risk of colon cancer

DISADVANTAGES OF HORMONE THERAPY

Risk of bleeding
Risk of growth of fibroids
Risk of breast tenderness
Possible headache or weight gain at the start
Risk of breast cancer when estrogen is combined with progestogen
Risk of blood clots in veins with oral tablets

EXERCISE STRENGTHENS BONES AND IMPROVES QUALITY OF LIFE

Exercise is the best “medicine” women can get during menopause. Sweating it out at the gym, swimming, running, cycling, taking the stairs, or playing sports reduces hot flashes and night sweats.

Exercise also has a positive effect on hormone balance. All hormone-related symptoms, including osteoporosis, are reduced. Any activity counts, including cleaning, gardening, or brisk walks with the dog.

RED CLOVER AND DIETARY SUPPLEMENTS

There are many types of plant-based estrogen supplements, marketed to relieve hot flashes and other menopausal symptoms.

However, a large review of 30 clinical studies including nearly 3,000 women showed that supplements with soy, red clover, or flaxseed did not significantly reduce hot flashes over time. These studies were conducted in women who had not had breast cancer.

There was no evidence of side effects from taking plant estrogen supplements for up to 2 years. A diet rich in plant estrogens also appears safe for women who have not had breast cancer.

The Danish Cancer Society advises extra caution with plant estrogen supplements in women who have had breast cancer or are undergoing anti-estrogen treatment.

WHAT IS THE BEST CHOICE FOR ME?

The decision is yours, in consultation with your doctor. It is important to understand the benefits and risks of hormone therapy.

Symptom relief can only be assessed after a few months of treatment. It is therefore a good idea to schedule a follow-up visit after about three months.

You and your doctor should review treatment annually. If you wish to continue hormone therapy for more than five years, the benefits, risks, and disadvantages should be reevaluated.

Book a consultation