Should You Avoid Hormone Replacement Therapy?

Since a landmark 2002 study on hormone replacement therapy for menopause, fewer and fewer doctors have prescribed hormone replacement therapy to their patients, and its use has been steadily declining. However, before you make a decision about hormone replacement therapy, you should understand its benefits and risks.

Benefits of Hormone Replacement Therapy

Women can take short term courses of hormone replacement therapies, usually a combination of estrogen and progestin (a manmade hormone biologically similar to progesterone) to ease the vaginal symptoms of menopause, which typically include dryness, itching, and burning, and can lead to discomfort with intercourse.

In addition to that, hormone replacement can slow the bone loss associated with menopause, which reduces the risk of osteoporosis-related bone fractures significantly even with a short course of hormone treatment. Some studies suggest that estrogen taken early enough in the postmenopausal period can reduce the risk of heart disease. Studies are going underway currently to determine whether this benefit works on younger women as well.

Risks of Hormone Replacement Therapy

There are a variety of significant risks caused by hormone replacement therapy. Treatment with estrogen alone is associated with an elevated risk of stroke and blood clots in the legs, as well as abnormal mammograms; adding progestin adds risk factors for heart disease and breast cancer, and worsens the rates for the side effects of estrogen replacement therapy alone.

These risks are fairly low; the highest reported rate is eighteen cases in 10,000 for blood clots in the legs under progestin and estrogen replacement therapy. However, they are significant enough that long-term hormone replacement therapy is no longer routine for all postmenopausal women.

Do You Need Hormone Replacement Therapy?

If you are suffering severe enough symptoms of menopause, the benefits of hormone replacement therapy may outweigh the added risks. Estrogen replacement remains among the most successful menopause relief therapies. It is particularly well-suited to women who experience premature menopause: menopause before the age of 40. Women with premature menopause have lower risks of breast cancer and higher risks of osteoporosis and coronary heart disease as compared to women who reach menopause nearer to the average age of approximately 50.

As always, you should talk to your doctor and consider your options carefully before you set out on a course of treatment for menopause symptoms. A treatment that works for your friends might not work for you, and vice versa.

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