So, Hormone Replacement Therapy… to use or not to use?
It’s a contentious topic, that’s for sure! In fact, over the past few decades, few other medical treatments have been prescribed with quite so much controversy. And, despite five decades of prescribing the treatment, many questions still remain regarding the risks and benefits.
Menopause is painfully serious for so many women. Around the ages 45 to 54 we say farewell to the hormones that regulate our reproductive life – chemicals send signals between our cells, like a sort of organic Twitter causing hot flashes, night sweats, vaginal dryness, and sleeplessness. 75 to 80% of menopausal women experience debilitating (and embarrassing) symptoms for anywhere from a couple of years to more than a decade. It’s as if nature decided that pregnancy, labour, breastfeeding, saggy boobs and stretchmarks weren’t hard enough, right?
But, in all seriousness, is HRT safe? For some women the symptoms of menopause can be severe and if you’re one of them HRT might be necessary to manage this life stage. And, it should be on the table, part of the discussion.
Fact is, the pendulum has surely swung from one extreme to another on this one. In 2015 the National Institute for Health and Clinical Excellence (NICE) stated that 85% of women going through menopause don’t get the help they need, and that HRT works and should be considered.
Long-term results from a study by the Women’s Health Initiative (WHI) still states that HRT increases the risk of breast cancer, ovarian cancer, and possibly heart disease and stroke in those over 60. However, WHI has recently published its long-term findings showing that women do not die from taking it. The risk of breast cancer from being overweight is four times higher. This is encouraging data for women to know that even if they take supplemental hormones for five to seven years, they will not experience an increased risk of dying any earlier from any cause than women who don’t take them. It will ultimately come down to each woman’s individual risk and family history.
The original WHI report showed that women taking a combination of estrogen and progesterone to counter menopausal symptoms had a higher rate of potentially life altering side effects, and that this should still make them pause. For women with a hysterectomy considering taking estrogen alone for menopausal symptoms, the effects on chronic diseases were more balanced, and the benefits for symptom relief may be worth it.
The benefits of hormone therapy may outweigh the risks if you’re healthy and you:
Experience moderate to severe menopausal symptoms.
Have lost bone mass and either can’t tolerate or aren’t benefitting from other treatments.
Stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40.
Despite the health risks systemic estrogen is still the most effective treatment for menopausal symptoms and as researchers learn more about hormone therapy and other menopausal treatments, recommendations may change.
So, ladies, talk to your doctor about your individual symptoms and health risks and be sure to keep the conversation going throughout your menopausal years.
Source: www.npjournal.org, www.health24.com, www.sciencedaily.com, obgyn.onlinelibrary.wiley.com, www.theguardian.com, www.today.com, www.sciencenews.org, www.fredhutch.org, www.mayoclinic.org, time.com, za.pinterest.com, www.prevention.com, spice4life.co.za
