Estrogen replacement therapy, hormone replacement therapy (HRT) and natural hormone replacement therapy, also known as bio-identical hormone replacement therapy, can all help relieve menopausal symptoms. However, there is much controversy surrounding whether to take them or not as there are many risks and benefits to be considered. The decision to begin HRT can be one of the most important health care decisions a woman makes. A woman’s overall health, her personal and family medical history, her lifestyle, and her fears about hormones are all significant in making the decision to start hormone replacement therapy.
The largest benefit most women receive from hormone therapy is relief from hot flashes, night sweats, sleep problems, vaginal dryness and anxiety. A woman's body produces less estrogen during and after menopause, which may affect her bone strength. Hormone therapy may also prevent osteoporosis from developing.
Hormone therapy is said to reduce the possibility of dental problems, such as tooth loss and gum disease. It may also slightly lower the risk of colon cancer.
As with all medicines, risks and side effects are possible. Some women taking hormone therapy may have water retention, bloating, nausea, breast soreness, irregular bleeding, mood swings, and headaches. (Changing the dose or form of hormone therapy may help reduce these side effects.)
Taking estrogen can increase a woman’s risk for blood clots. Generally, this risk is higher if the person is taking birth control pills, which contain high doses of estrogen. The risk can be higher in people who smoke and take estrogen.
Woman who take estrogen therapy for a long period of time have a small increase in risk for breast cancer. Most guidelines currently consider hormone therapy safe for breast cancer risk when taken for up to five years.
Estrogen may increase the risk of heart disease in older women. However, it may still be somewhat protective in preventing heart disease when given under certain circumstances. Estrogen is probably the safest for women under 60 years of age.
Women who take estrogen have an increased risk for stroke.