Hormone Replacement Therapy and Menopause
Menopause is a natural occurrence that takes place in a woman's life around the age of 50. Menopause is marked by bodily changes that represent the end of a woman's ability to bear children.
Like puberty, menstrual periods and pregnancy, menopause involves fluctuations in hormones, notably estrogen and progesterone. These fluctuations can cause symptoms that may make women uncomfortable, such as hot flashes, vaginal dryness, mood swings, and difficulty sleeping. As a result, many women discuss options that can make them feel more comfortable. Hormone replacement therapy may be a consideration.
What is hormone replacement therapy?
Estrogen levels fall during menopause. The online medical resource WebMD says that hormone replacement therapy, or HRT, involves taking small doses of estrogen alone or estrogen combined with progestin, the synthetic form of progesterone. Women who have undergone a hysterectomy or the surgical removal of their ovaries may only take estrogen, while a woman who still has her uterus typically takes the combination HRT. Many women find that HRT can relieve most of the troubling symptoms of menopause and help them feel more comfortable.
In addition, HRT has been proven to prevent bone loss and reduce fracture in postmenopausal women, according to the Mayo Clinic.
Types of products
There are different types of HRT. HRT may involve taking a pill or applying a patch, gel or vaginal cream. HRT also may include a slow-releasing suppository or a vaginal ring. The delivery method will depend on the symptoms to minimize the amount of medication taken.
Risks of HRT
While there are many benefits to HRT, there are some risks associated with the therapy. These risks depend on the dose, the length of time taking HRT and individual health risks.
The Mayo Clinic says that, in the largest clinical trial to date, HRT that consisted of an estrogen-progestin pill increased the risk of certain serious conditions, such as heart disease, stroke, blood clots, and breast cancer. Women who begin at age 60 or older or more than 10 years from the onset of menopause are at greater risk of the these conditions. If HRT is started before the age of 60 or within 10 years of menopause, the benefits appear to outweigh the risks.
In addition, unless the uterus has been removed, doctors typically prescribe estrogen taken with progesterone because estrogen alone can stimulate the growth of the lining of the uterus, increasing the risk of endometrial cancer.
The American Cancer Society says that estrogen-progestin therapy also is linked to a higher risk of breast cancer the longer the therapy is used.
Doctors can work with their patients to minimize the risk of developing adverse affects from HRT. Tactics include finding the best product and delivery method, seeking regular follow-up care, making healthy lifestyle choices to reduce other health conditions, and taking the lowest effective dose for the shortest amount of time needed.
Hormone replacement therapy may be an option to help manage the symptoms of menopause. Women can discuss the pros and cons of HRT with their doctors.