Estrogen Hormone Therapy and Menopause
For many years, Hormone Replacement Therapy (HRT) was the standard treatment for menopause symptoms such as hot flashes. It was also thought to have health benefits. Most notably, experts believed it helped prevent heart disease.
But a landmark study called the Women's Health Initiative showed that HRT did not protect women's hearts. In fact, long-term use of hormone therapy (both estrogen-only and combined estrogen-progestin) slightly raised the risk of stroke and blood clots in older women.
Combined therapy also raised the risk of heart attack. (The effect of estrogen-only menopausal therapy was not clear.) The increased risks were small, but they were enough to cause a dramatic shift in thinking about hormone therapy.
Since that first study, further research showed that combined HRT raises the risk of breast cancer in postmenopausal women with a uterus. Women who took estrogen alone had more abnormal mammograms but no increase in breast cancer.
Here is a brief summary of the findings.
Pros of Hormone Therapy
There are some benefits to be gained from undergoing this process, which are as follows:
- Reduces some bothersome menopause symptoms
- Helps protect against osteoporosis
- Lowers the risk of colon cancer
Cons of Hormone Therapy
Likewise, there are also some disadvantages to the process which are outlined as follows:
- Does not protect against heart disease
- Slightly raises the risk of heart attack, strokes, blood clots and, in some women, breast cancer
- Does not protect against Alzheimer's disease or dementia and may actually increase the risk
The bottom line: The risks of undergoing hormone therapy can outweigh the benefits for many women, depending on their health record. Medical experts continue to study estrogen and progestin and their separate and combined effects on the body.
Until more is known, each woman who is considering taking this form of therapy should first weigh up the pros and cons of HT based on her personal health history. It is also beneficial to discuss the issue with a medical professional counsellor, doctor or gynaecologist.
What are the Current Recommendations?
Despite the perceived advantages and disadvantages, Hormone Replacement Therapy is still the most effective treatment for moderate to severe menopause symptoms. Your doctor might recommend it to:
- Decrease hot flashes, night sweats, vaginal dryness and other menopausal symptoms
- Prevent bone loss if you are not able to use other medications for this purpose
There are many benefits that go along with this type of therapy, mainly related to improving the way you feel, reducing hot flashes and helping to get a better night's sleep are all highly desirable side-effects. In any case, it is best if either alternative type of HRT is taken at the lowest dose and for the shortest time possible to relieve symptoms.
HT should not be used as a means to prevent heart disease. Other medications and lifestyle changes offer more effective and safe ways to prevent this.
The final choice about whether to take hormone therapy is up to you. Your doctor can help you weigh the severity of your menopause symptoms against your disease risks so you can make the best decision for you.