Hormone Replacement Therapy Information

If you are approaching menopause or perimenopause, you've most likely heard a lot about hormone therapy. Whether it's using prescription medication or natural phyto-estrogens, hormone replacement therapy (or HRT) has benefits and risks. Making an informed decision is crucial to protecting your long-term health.

The Facts About Menopause

• Menopause brings a host of bodily changes. The most notable change is the decrease in your ovaries' production of progesterone and estrogen. This decline in hormone production is what puts a stop to ovulation and menstruation. This is also what causes many of the other menopausal symptoms like urinary problems, mood swings, vaginal dryness and hot flashes. Decades of traditional medicine has prescribed hormone replacement therapy to supplement the hormones no longer being manufactured by your body. Initial research indicated that elevating levels of estrogen after menopause actually could prevent osteoporosis and heart disease. More recent reports, like the research conducted in 2002 by the Women's Health Initiative (or WHI, a large-scale clinical trial) indicate that there are a number of hazards associated with HRT. The question for each individual woman becomes this: Does the benefit outweigh the risk?

Summary of Benefits

• Benefits of HRT include relief from night sweats, hot flashes and vaginal changes (like burning, dryness, itching and uncomfortable intercourse). When HRT is recommended, it is generally for short-term relief of symptoms. When estrogen is prescribed to alleviate menopausal symptoms, it is usually combined with progestin since estrogen alone may increase the threat of uterine cancer in women who undergo natural menopause (as opposed to those who undergo a hysterectomy).

Additional Benefits

• Additional HRT benefits include possible protection from some diseases and conditions like:
  Heart disease: KEEPS (the Kronos Early Estrogen Prevention Study) is currently ongoing to evaluate early use of estrogen during postmenopausal years and a possible link to decreased heart disease.
  Osteoporosis: Short-term estrogen supplementation can help to prevent significant post-menopausal bone loss.
  Colorectal Cancer: Ongoing research indicates that HRT may decrease post-menopausal women's risk of colorectal cancer.

Risks

• In 2002, the WHI studied HRT risks. Research suggested that HRT posed more risks than benefits. The WHI found that women taking the estrogen-progesterone combination experience an increased risk of certain conditions like heart disease, breast cancer, blood clots and stroke. Additionally, researchers discovered that these women also experienced an increase in abnormal mammogram results (false positives) due to increase density of breast tissue (as a result of the estrogen supplementation).
  The WHI research indicated that women taking estrogen only had no increased risk of heart disease or breast cancer. They did, however, experience more incidences of stroke, blood clots and mammogram abnormalities.

Considerations

• If you do decide to take hormone replacement, you can protect yourself. Women under age 60 do not experience a significant risk of increased heart disease. Using the lowest dose possible for the shortest time possible will help decrease your risk. Depending on your specific menopausal symptoms, you may take HRT as a pill, vaginal cream, suppository, gel or patch. If you have a history of blood clots, heart disease or breast cancer, you should not take HRT. If you do not suffer from the symptoms of menopause, you should not take HRT. Talk to your doctor to determine if HRT is right for you. Choosing the right timing, the right dose and the right delivery method can help maximize the HRT benefits while minimizing the HRT risks.