Hormone replacement therapy (HRT), or hormone therapy as it is called today, is the use of medications that contain female hormones designed to replace those no longer produced by the body as a result of menopause. For years, HRT was accepted as the primary treatment of menopausal symptoms, and it was also praised as having long-term benefits in the prevention of heart disease and dementia in women.
However, in 2002, a large clinical trial produced results indicating that HRT actually posed more dangerous health risks than benefits, particularly for older menopausal and postmenopausal women. As concerns and negative facts emerged, doctors refrained from prescribing HRT for the treatment of heart disease and cognitive problems and greatly reduced the use of it as a menopausal treatment. More recent tests, trials, and medical opinions, though, show that HRT may be a beneficial choice for certain women, depending on the risk factors for an individual woman.
There are two types of hormone therapy available today:
1) Systemic, which is the replacement of estrogen. This is considered to be the most effective treatment for hot flashes and vaginal dryness, although it is not recommended for the prevention or treatment of osteoporosis or for long-term use. Systemic treatment is available in the forms of a pill, a skin patch, or vaginal creams and sprays.
2) Low-dose vaginal products which also replace estrogen with minimal bodily absorption. These low-dose products, however, do not help with hot flashes, night sweats, or osteoporosis reduction. They are only considered effective with menopausal vaginal problems and some urinary symptoms. Low-dose vaginal products come in the forms of a pill, a gel cream, or a vaginal estrogen ring that can be worn permanently as long as symptoms are present.
Candidates for hormone therapy must be evaluated on a case-by-case basis. Good candidates are healthy women who have a family history of osteoporosis or moderate to severe menopausal symptoms or experience premature menopause. Poor candidates are those women who have had breast cancer, heart or liver disease, or a history of blood clots. Women with no menopausal symptoms, but who have osteoporosis or dementia, and those with nicotine and/or drug addictions should not seek HRT.
The risks of using hormone therapy, according to research, are varied. They include an:
Increased risk of breast cancer when used long-term
Increased risk of heart disease and stroke
Increased risk of early or regular onset of dementia
Increased risk of blood clots
Nonetheless, it is possible to reduce these risks by working with your doctor to determine the most suitable product and delivery method for you, and by taking the lowest effective dosage of treatment over the shortest period of time necessary.
The benefits of using one of the two methods of hormone therapy also vary from woman to woman. A couple of benefits include:
An increase in and the maintenance of hormone levels
As a treatment for osteoporosis when other approaches fail
It is also possible to increase the benefits of HRT through follow-up by regular medical
evaluations, eating healthy and exercising, avoiding alcohol and smoking addictions, and by controlling health conditions, such as high blood pressure and cholesterol.
For some of the women who experience premature menopause, the protective benefits of hormone therapy will often outweigh the risks, but that is not true for all women. Emphasis has to be placed on each individual case, as there is no blanket prescription for hormone replacement that will suit every woman.
Typically, women who are not troubled by menopause symptoms, or who started menopause after the age of forty-five, do not need hormone therapy to stay healthy. Each woman must decide for herself whether HRT is suitable in her case, but that decision must be made in consultation with her doctor after all the circumstances, benefits, and risks are identified. Most importantly, the conversation should continue over the menopausal years – it is not a one-time discussion!