It's likely you've heard the stern warnings over the past few years regarding hormone replacement therapy, and, if you were taking HRT, your doctor may have even stopped prescribing the hormones for you. Not only was HRT once considered the standard treatment for women who were experiencing unmanageable menopause symptoms and hot flashes, it was also believed to prevent heart disease and osteoporosis. In 2002, attitudes toward hormone therapy took an abrupt turn when a large clinical trial found the treatment posed more health risks than benefits for postmenopausal women.
Benefits of Hormone Therapy
Despite the hormone therapy scare, they still possess some benefits for women such as protection from osteoporosis; studies have shown that hormone therapy successfully prevents the typical bone loss women experience following menopause and decreases the risk of hip fractures in women. Hormone therapy has been shown to decrease the risk of colorectal cancer and decrease the risk of heart disease when taken early in the postmenopausal years. The typical hormone prescribed is estrogen along with progestin, which is a man-made version of progesterone. Estrogen alone can increase the risk of uterine cancer, therefore women who have had a hysterectomy care the only ones who can safely take estrogen without the progestin.
Risks of Hormone Therapy
Unfortunately, there seems to be many more risks than benefits in taking the combination estrogen-progestin hormone therapy known as Prempro. In the largest clinical trial yet, it was found that over a time period of one year, out of 10,000 women who were taking estrogen plus progestin, there would likely be seven more cases of heart disease, eight more cases of breast cancer, eight more cases of stroke, eighteen more cases of blood clots, and an increase in false positive mammograms. The same number of women taking estrogen only could be expected to experience twelve more cases of stroke, six more cases of blood clots in the legs and a significant increase in mammography abnormalities. As you can see, the risks are high compared with the benefits for most women.
What if My Menopausal Symptoms are Severe?
In spite of the obvious health risks, if you suffer from severe menopausal symptoms such as moderate to severe hot flashes, have lost bone mass and could not tolerate other treatments, or stopped having periods before the age of forty, hormone therapy could still be right for you. Talk with your doctor, and realize that the absolute risk of heart disease to an individual woman taking hormone therapy is relatively low, and your individual risk of developing heart disease is also highly dependent on your family medical history, personal medical history and lifestyle choices.
If You Do Decide to Take Hormone Therapy
Should you and your doctor agree that the benefits outweigh the risks for you personally, try to minimize the amount of medication you take by using the lowest effective dose for the shortest amount of time to successfully manage your symptoms. You could also try the form of hormone therapy with the least amount of systemic effects, such as a vaginal cream, ring, or tablet which will minimize the level of hormones absorbed into your bloodstream. Make healthy lifestyle choices by not smoking, getting regular physical activity, eating a healthy diet, and maintaining a healthy weight. Additionally, make sure you get your regular health screenings in order to detect any early signs of heart disease.