Hormone Replacement Therapy – Is it Right for You?
Menopause can sometimes bring with it uncomfortable changes to a woman’s body, and this new development often results in women turning to hormone replacement therapy for help. Hormone replacement therapy used to be the norm for women seeking relief for menopausal symptoms, but some recent studies sensationalized by the media suggested that the adverse effects resulting from hormone replacement therapy might outweigh the benefits. The studies have since received widespread criticism, but the question remains if hormone replacement therapy is both suitable and beneficial for the majority of menopausal women. A dozen doctors will probably tell you a dozen different things, but it all essentially boils down to each woman’s particular situation.
Hormone replacement therapy consists of two hormones: estrogen and progestogen. Women who have an estrogen deficiency will notice several changes with the onset of menopause, including hot flashes, vaginal changes, loss of interest in sex, and a general change in their mental outlook such as poor memory, gloominess, and irritability. Hormone replacement therapy is designed to alleviate these symptoms, and for the majority of women it works quite well with very few side effects.
For some women, hormone replacement therapies are introduced in the Perimenopausal stage in conjunction with birth control. This means that if you are noticing some of the symptoms noted above but still have your period, you may indeed be a candidate for hormone replacement therapy.
It can be administered any number of ways similarly to birth control such as orally, vaginally, or implanted. Women who have certain preexisting conditions, such as diabetes, should avoid oral therapies but can utilize other methods. Dosage should always start at the lowest dose to first see how the woman’s body reacts, and then slowly increase the dosage as needed to ease symptoms. It is important to note that once hormone replacement therapy is stopped, the symptoms you were treating may come back in full force.
For some women, hormone replacement therapy can help prevent certain ailments that they may a genetic predisposition towards or otherwise be at risk of developing. Hormone replacement therapy can help prevent osteoporosis, but this benefit stops when the treatment stops. If the only reason a woman is considering hormone replacement therapy is because she is at risk for osteoporosis there are better preventative treatments that can be used instead. Hormone replacement therapy may also lower the incidence of Alzheimer’s in women under age seventy-five, and in some cases can help prevent colon cancer. Currently there is a hot debate in the medical community as to whether hormone replacement therapy can lower the risk of cardiovascular disease. Some researchers are of the opinion that there are better ways to reduce the risk of cardiovascular disease instead of relying on hormone replacement therapy.
Hormone replacement therapy does raise the risk for certain ailments. The risk of developing breast cancer while taking hormone replacement therapy is higher than normal in the first few years of therapy, but five years after the woman stops taking hormone replacement therapy the risk returns to normal. The rate of venous thromboembolism, which is when a dislodged blood clot blocks a blood vessel, is higher during the first year of hormone replacement therapy. Utilizing estrogen-only therapy for over ten years may result in a higher likelihood of developing ovarian cancer. Research also suggests that hormone replacement therapy may result in a higher likelihood of incontinence, but this research was conducted on menopausal women with heart disease.
For women not wanting to delve into a hormone replacement therapy program there are several excellent holistic approaches that can be used instead. Lifestyle changes such as regular exercise, a healthy diet, and taking herbal supplements can reduce some of the discomfort associated with menopause, but these healthy habits generally need to be accomplished at a regular rate in order to reap the benefits.
Your health care professional is the best person to talk to in order to find out if hormone replacement therapy is right for you. Your doctor will discuss your prior health history along with current concerns and discomforts, and then work with you to create a therapy program that will help you feel a little more like your old self again.
(Feb, 2006) More evidence that hormone replacement therapy causes incontinence in post-menopausal women. British Medical Journal, 332, (753
Other Body Changes Due to Menopause
Menopause is the time in a woman's life when her period stops. It is a normal change in a woman's body. A woman has reached menopause when she has not had a period for 12 months in a row (and there are no other causes, such as pregnancy or illness, for this change). Menopause is sometimes called, "the change of life." Leading up to menopause, a woman’s body slowly makes less and less of the hormones estrogen and progesterone. This change often happens between the ages of 45 and 55 years old. As you near menopause, you may have symptoms from the changes your body is making. Many women wonder if these changes are normal, and many are confused about how to treat their symptoms. You will feel better by learning all you can about menopause and talking with your doctor about your health and your symptoms. If your symptoms are causing you discomfort or concern, your doctor can teach you about treatment options and help you to make wise treatment choices.
What are the symptoms of menopause affect every woman differently. Your only symptom may be your period stopping. You may have other symptoms, too. Many symptoms at this time of life are because of you getting older. However, some are due to menopause. Common symptoms of menopause include:
- Change in pattern of periods (can be shorter or longer, lighter or heavier, more or less time between periods)
- Hot flashes (sometimes called hot flushes), night sweats (sometimes followed by a chill)
- Trouble sleeping through the night (with or without night sweats)
- Vaginal dryness
- Mood swings, feeling crabby, crying spells (probably because of lack of sleep) Trouble focusing, feeling mixed-up or confused
- Hair loss or thinning on your head, more hair growth on your face
When a woman is young, estrogen helps to keep bone strong. When estrogen levels fall at menopause, bones weaken. When bones weaken a lot, the condition is called osteoporosis. Weak bones can break more easily. Many women experience bone loss after menopause. There are plenty of things a woman can do to avoid the side effects of menopause. Eating a healthy diet and exercising at menopause and beyond are important to feeling your best. Most women do not need any special treatment for menopause. However, some women may have menopause symptoms that need treatment. Several treatments are available. It's a good idea to talk about the treatments with your doctor so you can choose what’s best for you. There is no one treatment that is good for all women. Sometimes menopause symptoms go away over time without treatment, but there’s no way to know when.
Hormone therapy (HT): If used properly, hormone therapy (once called hormone replacement therapy or HRT) is one way to deal with the more difficult symptoms of menopause. It's the only therapy that is approved by the government for treating more difficult hot flashes and vaginal dryness. Hormone therapy should NOT be used solely to prevent heart or bone disease, stroke, memory loss, or Alzheimer's disease. There are many kinds of hormone therapies so your doctor can suggest what's best for you. As with all treatments, HT has both possible benefits and possible risks. If you decide to use HT, use the lowest dose that helps and for the shortest time needed.
HT can help with menopause by:
- Reducing hot flashes
- Treating vaginal dryness
- Slowing bone loss
- Improving sleep (and thus decrease mood swings)
For some women, HT may increase their chance of:
- Blood clots
- Heart attack
- Stroke
- Breast cancer
- Gall bladder disease
Some women decide to take herbal or other plant-based products to help relieve hot flashes. Soy contains phytoestrogens. Nevertheless, there is no proof that soy really does make hot flashes better. The best sources of soy are foods such as tofu, tempeh, soymilk, and soy nuts. These soy products are more likely to work on mild hot flashes. Other sources of phytoestrogens include herbs such as black cohosh, wild yam, dong quai, and valerian root. Again, there is no proof that these herbs (or pills or creams containing these herbs) help with hot flashes. Products that come from plants may sound like they are safe, but there is no proof they really are. There also is no proof that they are better at helping symptoms of menopause. Make sure to discuss these types of products with your doctor before taking them. You also should tell your doctor about other medicines you are taking, since some plant products can be harmful when combined with other drugs.