Hormone Replacement Therapy
Alternate Names : HRT, Estrogen Replacement Therapy, ERT
Hormone replacement therapy, called HRT, is the use of man-
made or natural hormones to treat a person whose body is
no longer making enough of certain hormones. It is often prescribed for women in
menopause.
It is also given to women who have had their ovaries removed. HRT for
menopause
usually consists of the hormones estrogen and progesterone taken together.
Estrogen may also be taken alone. This is called estrogen replacement
therapy, 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 enter
menopause
or have their ovaries removed. Low levels of estrogen produce the common
symptoms of menopause:
painful intercourse, a condition known as
dyspareunia
hot flashes
mood changes
night sweats
sleep disorders
vaginal dryness
HRT is often given to reduce
these symptoms. Women who have had their uterus and ovaries
removed generally take estrogen alone. Women who still have their
uterus need progesterone along with estrogen. This is because taking
estrogen alone can increase the risk of cancer of the uterus.
Recent studies have looked at the link between
HRT and memory in women. Here are some recent findings.
Estrogen use after menopause
did not reduce a woman's risk for Alzheimer's disease.
HRT did not slow the rate of memory loss
in women after menopause.
Perimenopause
Perimenopause
is the time when a woman may be having sporadic periods but has not
yet reached menopause.
Women are sometimes given oral contraceptives
at this time. These medicines control irregular menstrual periods and
symptoms of menopause. They typically contain both estrogen and
progesterone at higher doses than are used in HRT.
Because a woman may continue to ovulate during
perimenopause,
it is still possible for her to become pregnant.
A woman who wants to avoid
pregnancy should use birth control until a blood test shows that
menopause
is present. Or, she should use birth control until she does not have a
period for 12 months in a row. After that, she may switch to the lower
doses of hormones in HRT. The hormone doses in HRT are not
high 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 fractures
in the hip and spine from osteoporosis
relief of hot flashes
and 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 decrease
their risk of heart disease. However, experts found that there was also
an increase in stroke
and heart attack
in women taking HRT. So, in 2002, the Women's Health Initiative
recommended that women not be started on HRT just to prevent heart disease.
Risks of HRT
Research has shown several risks associated with taking
HRT or ERT.
HRT and ERT increase the risk of breast cancer
HRT slightly increases a woman's risk for stroke
and 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 as
deep venous thrombosis
and pulmonary embolism.
If a woman still has her uterus, taking estrogen alone increases the risk of
cancer 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 with
menopause and
perimenopause,
such as:
Do nothing.
Take birth control pills
to control irregular periods during perimenopause.
Take HRT or ERT during menopause
to 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 as
HRT 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 upon
the proven benefits and risks of HRT. Women should discuss the
benefits and risks with their doctors. Together, they can choose the best
course of action.
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