What is hormone replacement therapy?
Hormone replacement therapy, or HRT, was once called the “Elixir of Youth.” Women’s doctors gave them medications containing female hormones to replace the ones the body doesn’t make after menopause, using HRT to treat menopausal symptoms. It was also thought to help prevent heart disease and possibly dementia.
Then, large clinical trials showed health risks.
What are the current recommendations?
Doctors no longer prescribe hormone therapy for heart disease or memory loss prevention. However, further research and new evidence show that hormone therapy may be a good choice for certain women, depending on their risk factors.
Who should consider hormone therapy?
The benefits of hormone therapy may outweigh the risks if you’re healthy and:
- Experience moderate to severe hot flashes or other menopausal symptoms
- Have lost bone mass and either can’t tolerate or aren’t benefitting from other treatments
- Stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40 (premature ovarian insufficiency)
Why? Because women who experience early menopause, particularly those who had their ovaries removed, have a higher risk of:
- Coronary heart disease
- Earlier death
- Parkinsonism (Parkinson’s-like symptoms)
- Dementia
- Anxiety or depression
- Sexual function concerns
Who should avoid hormone therapy?
Women with current or past history of breast, ovarian or endometrial cancer, blood clots to the legs or lungs, stroke or liver disease should not take hormone therapy. Smokers should also not take hormone therapy.
If your menopause symptoms started after age 45 and are not bothersome, you shouldn’t need hormone therapy to stay healthy. There are other strategies you can follow to reduce the risk of conditions such as osteoporosis and heart disease.
If you use hormone therapy, how can you reduce risk?
Work with your doctor to:
- Find the best product and delivery method for you. You can take estrogen in the form of a pill, patch, gel, or vaginal cream, ring or suppository.
- Minimize the amount of medication you take. Use the lowest effective dose for the shortest amount of time needed to treat symptoms.
- Have regular screenings such as mammograms and pelvic exams and keep in touch with your health care provider to ensure that the benefits of hormone therapy continue to outweigh the risks.
- Make healthy lifestyle choices, such as exercising, eating a healthy diet, maintaining a healthy weight and managing chronic health conditions such as high cholesterol or high blood pressure.
Your age, type of menopause and time since menopause began play a significant role in the risks associated with hormone therapy. Educate yourself and talk with your doctor about your personal risks.
At Chouchani, Sayegh and Bagnarello, we talk to each and every patient about making the best possible choices for their health. If you’d like to work with a practice that cares, please call any time.
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