Estrogen Replacement Therapy Hormone Replacement Therapy

Hormone replacement therapy, called HRT, is the use of man-made or natural hormones to treat a person whose body isno longer making enough of certain hormones. It is often prescribed for women inmenopause.It is also given to women who have had their ovaries removed. HRT formenopauseusually consists of the hormones estrogen and progesterone taken together.Estrogen may also be taken alone. This is called estrogen replacementtherapy, and is also known as ERT.

What is the information for this topic?

HRT has both benefits and risks.

Menopause

Estrogen levels drop when women entermenopauseor have their ovaries removed. Low levels of estrogen produce the commonsymptoms of menopause:

painful intercourse, a condition known asdyspareunia

hot flashes

mood changes

night sweats

sleep disorders

vaginal dryness

HRT is often given to reducethese symptoms. Women who have had their uterus and ovariesremoved generally take estrogen alone. Women who still have theiruterus need progesterone along with estrogen. This is because takingestrogen alone can increase the risk of cancer of the uterus.

Recent studies have looked at the link betweenHRT and memory in women. Here are some recent findings.

Estrogen use after menopausedid not reduce a woman’s risk for Alzheimer’s disease.

HRT did not slow the rate of memory lossin women after menopause.

Perimenopause

Perimenopauseis the time when a woman may be having sporadic periods but has notyet reached menopause.Women are sometimes given oral contraceptivesat this time. These medicines control irregular menstrual periods andsymptoms of menopause. They typically contain both estrogen andprogesterone at higher doses than are used in HRT.

Because a woman may continue to ovulate duringperimenopause,it is still possible for her to become pregnant.A woman who wants to avoidpregnancy should use birth control until a blood test shows thatmenopauseis present. Or, she should use birth control until she does not have aperiod for 12 months in a row. After that, she may switch to the lowerdoses of hormones in HRT. The hormone doses in HRT are nothigh enough to prevent pregnancy.

Benefits of HRT

These are the potential benefits of HRT:

decrease in LDL,which is also called the bad cholesterol

decrease in total blood cholesterol

increase in HDL,also known as the good cholesterol

prevention of bone fracturesin the hip and spine from osteoporosis

relief of hot flashesand vaginal dryness

slowing of bone loss and osteoporosis

slight decrease in colorectal cancer

HRT improves the levels of lipids in the body. Because of this,this therapy was often prescribed for menopausal women to decreasetheir risk of heart disease. However, experts found that there was alsoan increase in strokeand heart attackin women taking HRT. So, in 2002, the Women’s Health Initiativerecommended that women not be started on HRT just to prevent heart disease.

Risks of HRT

Research has shown several risks associated with takingHRT or ERT.

HRT and ERT increase the risk of breast cancer

HRT slightly increases a woman’s risk for strokeand heart attack

HRT can increase a woman’s risk for gallbladder disease.

HRT and ERT can increase a woman’s risk of blood clots, such asdeep venous thrombosisand pulmonary embolism.

If a woman still has her uterus, taking estrogen alone increases the risk ofcancer of the uterus.Adding progesterone reduces her risk to that of women who do not take ERT.

Deciding about HRT

A woman can choose from several strategies to cope withmenopause andperimenopause,such as:

Do nothing.

Take birth control pillsto control irregular periods during perimenopause.

Take HRT or ERT during menopauseto improve symptoms.

Use natural alternatives to HRT, such as foods high in phytoestrogens.These, however, have not been proven to have all of the same benefits asHRT or ERT.

Use estrogen creams for vaginal dryness.Creams do not help with other symptoms of menopause.

Overall, the decision to use HRT should be based uponthe proven benefits and risks of HRT. Women should discuss thebenefits and risks with their doctors. Together, they can choose the bestcourse of action.