Hormone Replacement Therapy & Stroke Risk

To alleviate menopausal symptoms, some women turn to hormone replacement therapy; however, recent findings appear to be mixed on whether this treatment increases the risk of stroke. Understanding your risk for stroke, as well as possible alternatives to HRT, can help you make an informed decision for treating troublesome symptoms.

Function

• Hormone replacement therapy consists of several types of treatments that include synthetic forms of the hormones estrogen, progesterone and sometimes testosterone. HRT can be given in several forms, such as creams, patches or gel, and is usually taken for only a few years.

Effects

• A study by Dr. James Liu, chairman of the Department of Obstetrics and Gynecology at MacDonald Women's Hospital, shows that no matter when therapy is started, it increases the risk of stroke, though the risk does appear to be lower in younger women. Those who take medium to high doses appear to be most at risk.

  The study followed 121,700 women on HRT from 1976-2004. During the study, 774 women had a stoke, and of those, 414 were taking HRT. In addition, higher doses of estrogen increased the risk of stroke by 62 percent.

Theories/Speculation

• Another smaller study showed an outcome quite different than Liu's. The Department of Clinical Sciences in Malmo, Sweden, studied 16,906 women aged 45-73 for 10.5 years. During this time, there were 461 stroke cases; however, only 48 out of the 461 were users of HRT. The study did find, though, that women taking unopposed estrogen had an increase of strokes.

  The study concludes that the risk of stroke is actually 33 percent lower in women who started HRT before menopause. Stroke risk increased with other risk factors, such as age, smoking and weight. Both studies confirm that the risk of stroke increases as a woman ages.

Considerations

• Liu says that if you're on HRT, use the lowest dose possible for only a short duration to effectively control your symptoms. Continual monitoring by your health care provider and understanding your personal risk factors, such as age, smoking, overweight and hypertension, are important parts of hormone replacement therapy.

Alternatives

• You can control symptoms with proper diet, exercise that includes both aerobic and strength training, and lifestyle choices. In addition, Marilyn Shannon, author of "Fertility, Cycles and Nutrition," says mood swings and other problematic menopausal symptoms can be avoided or improved by nutrition. She recommends Vitamins A, B, C and E, as well as the minerals magnesium, zinc and manganese. Also, essential fatty acids help to form necessary hormones. Find these fatty acids in safflower or flax oil.

  Shannon states that 3 milligrams of boron, an essential trace mineral found in fruits, vegetables and nuts, raises estrogen levels as much as a small dose of hormone replacement therapy.