Hormone Replacement Therapy in Menopause

It seems like Hormone Replacement Therapy (HRT) for the treatment of menopausal symptoms is back in the news – in a good way.  Ever since the Women’s Health Initiative (WHI) came out in 2002, patients have been running from this valuable medication.  Ten years since the premature release of their data, we now know that really nothing has changed over the last 55 years.  We have lowered the doses and shortened the duration of treatment but HRT still has more benefits than risks for most women.

Currently HRT and estrogen therapy alone (ERT) are recommended for symptomatic women only.  This is unfortunate since they have so many health benefits other than treating hot flashes and night sweats.  HRT which is estrogen and progesterone is offered to women who still have their uterus and ERT is for those without.  WHI did show an increased risk of blood clots and heart disease but this was primarily in older women (>65 y/o).  The increased risk of breast cancer was only seen in the HRT group and only with prolonged use.  Hormones have always been used prevent and treated osteoporosis (bone loss); in fact, they work better than any other of the multiple drugs currently on the market (don’t forget exercise, calcium, and Vit. D however).  Certain hormones have favorable effects on cholesterol, prevent colon cancer, may help prevent dementia, improve sexual function, and help improve incontinence.  Of course they are best known for ameliorating hot flashes, night sweats, vaginal dryness, and mood swings.

The decision to start HRT is important – next, which one to take:  traditional, bio-identical, compounded, patch vs pills or the many other non-hormonal options will take some study as well.  Visit our health library for more information.

Doc O