Hormone replacement therapy has been used to treat menopausal symptoms successfully for decades. Tens of thousands of women have experienced the benefits of this revolutionary treatment plan and have been able to enjoy a healthy and fruitful post-menopausal life. But a handful of studies performed on hundreds of women seem to challenge the benefits of hormone replacement therapy. The results from the main study, done by the Women’s Health Initiative (WHI), were released almost ten years ago and have stirred a debate among experts on how hormone therapy can help menopausal women. The debate, which is still ongoing, gave the impression that experts don’t agree on hormone therapy as a whole, but they do agree on the key points. Let’s take a look at what this means for you.
The beginnings of hormone therapy for menopausal women
Hormone therapy was first used to treat menopausal symptoms during the late 1980s and quickly became standard treatment for thousands of women. This new treatment method was also widely believed to have long-term benefits in preventing dementia and heart disease. The medical community was abruptly shaken when a study showed that hormone therapy could pose serious health risks, especially when given to older post-menopausal women. Consequently, doctors have begun to avoid prescribing HT to their patients and the medical community entered a long debate about the benefits vs. risks entailed by this treatment method.
What are the benefits of hormone therapy?
Although there is an ongoing debate about the efficiency of hormone therapy, experts agree on a number of important benefits. However, they depend on what type of hormone therapy you are on:
• Systemic hormone therapy
By far the most common HT procedure, systemic hormone therapy uses systemic estrogen as the main hormone. It comes in gel, pill, skin patch or spray and it is the most effective relief for menopausal night sweats, hot flashes, vaginal dryness, itching, burning as well as many other symptoms. Also, according to the FDA (Food and Drug Administration), estrogen can be successfully used to prevent bone-thinning (osteoporosis), especially when used together with bisphophonate-based drugs.
Long-term systemic hormone therapy has been shown to decrease the risk of heart disease, particularly when taken during the early stages of menopause.
• Vaginal estrogen preparations
Also known as low-dose vaginal products, these hormone preparations come in tablet, foam or ring form, and can treat vaginal and urinary symptoms. Because they have a limited absorption into the body, they are not effective against common menopausal symptoms, such as night sweats or hot flashes.
• Progesterone and progestin
Many women who already undergo estrogen hormone therapy will also have to take progesterone or progestin. This is because an only estrogen-based hormone therapy can increase the risk of uterine cancer, and progesterone helps the body regain its hormonal balance. Women who have had their uterus removed don’t have to take additional progesterone or progestin.
What are risks of hormone therapy for menopausal women?
While the benefits of hormone therapy are multiple and many patients have managed to fight the menopausal symptoms, there are some risks which need to be taken into consideration. According to a large clinical test performed in 2012, a common pill used in hormone therapy (Prempro, a combination of estrogen and progestin) can increase the risk of stroke, heart disease, blood clots and breast cancer. On the other hand, a clinical test which focused on Premarin (an estrogen pill) and performed on women who have had their uterus removed, found to relevant increase in the risk of heart disease, stroke or breast cancer.
Various other studies have shown that a combination hormone therapy (estrogen and progestin) may make your breast look more dense in a mammogram, especially after undergoing therapy for multiple years. This makes the detection of breast cancer harder and may increase the mortality rates. The risks of hormone therapy are closely linked to other factors, such as the age of the patient, the preexisting medical conditions, the age of menopause onset and the patient’s family medical history. Because these risks are fairly complex and very patient-specific, they must be discussed with your endocrinologist before deciding if hormone therapy is right for you.
Should you consider hormone therapy?
Although there are some health risks associated with hormone therapy, this treatment plan still remains the best way to fight menopausal symptoms. Hormone therapy still works, particularly if you are healthy. You should consider HT:
• if you lost bone mass and don’t seem to benefit from other treatments
• if you regularly experience menopausal symptoms, such as moderate to severe night sweats and hot flashes, vaginal dryness or itching
• if you suffer from premature menopause (you stopped having periods before or around the age of 40)
One thing is for certain, hormone therapy has its good and bad points; and the medical community agrees with this statement. There are benefits which can outweigh the risks, but it all depends on the patient. To determine if you are a good candidate for hormone therapy, you should talk to your doctor and an endocrinologist. Companies like Body Concepts can assist and advise you on if hormone therapy is a viable option for you. Also, pay attention to how your body changes and adapts throughout your menopausal years and keep in touch with your doctor at all times.