We are fortunate to live in an era with unprecedented access to information thanks to the Internet. With the right keywords and a quick search, seemingly unlimited results appear right at our fingertips.
And yet with this access comes a double-edged sword – experts. Some experts will tell you hormone replacement therapy is perfectly safe for women to take. Others will tell you it is not. Still others will fall somewhere in the middle, leaving a wide gulf of questions and confusion for women who feel overwhelmed and bewildered.
If the so-called “experts” can’t agree on the facts of hormone replacement therapy, how in the world are we supposed to know? And furthermore, how can we possibly make an informed decision if we can’t find accurate and consistent information?
Thankfully, it’s not as bleak as it may seem. While it is true that experts disagree and may continue to disagree, it is still possible sort the myths from the facts on hormone replacement therapy so you can make the best decision for your health.
First Things First: What Exactly is Hormone Replacement Therapy?
Hormone replacement therapy, also known as HRT, hormone therapy, menopausal therapy, and estrogen therapy, is the use of the female hormones, estrogen and progesterone, to treat and manage reproductive issues in women.
Hormone replacement therapy has gone through many evolutions in terms of its name, how it is used, and what it is used for. But, primarily, it is used to treat and manage the symptoms associated with both perimenopause and menopause.
Hormone Replacement Therapy for Perimenopause Symptoms
When women enter perimenopause, their hormones begin to fluctuate (sometimes wildly) and produce a variety of bothersome symptoms such as hot flashes, night sweats, insomnia, erratic menstrual cycles, vaginal dryness, loss of libido, and unwanted weight gain.
Hormone replacement therapy can be extremely effective in treating and managing these symptoms for a lot of women by balancing hormones and stabilizing fluctuations. Two of the most common symptoms of perimenopause, hot flashes and night sweats, both caused by fluctuating and low levels of estrogen, can be managed using estrogen therapy.
However, it is also important to understand the benefits of estrogen must be balanced with progesterone to help guard against any increased risk for uterine cancer in women who still have a uterus.
But is it Safe?
Since the Women’s Health Initiative study was released in 2002, a broad, sweeping swath of misinformation and confusion has surrounded the use and safety of HRT. The biggest misconception is that hormone replacement therapy puts all women at greater risk for breast cancer, heart disease, stroke, and blood clots when this is not the case.
The study focused on the results from older women, mean age of 63, and indicated that hormone replacement would not protect women from coronary heart disease. Instead, they found that HRT increased their risk of blood clots and breast cancer.
However, younger women, who are more likely to use HRT for a shorter period of time to manage perimenopause symptoms, were not included in the study.
Since then, physicians have begun to favor the judicious use of hormone replacement therapy and consider it safe and effective for most women. The recommendations are that it should be used in the early years of perimenopause, for the shortest time possible, and at the lowest dose possible. Transdermal patches and gels (through the skin) are often used because they allow physicians to individualize treatment for their patients and more effectively monitor the dose.
But I’m in Menopause: Is it Safe for Me?
For some women, reaching menopause brings an end to most if not all of the symptoms of perimenopause. However, many of us do continue to suffer with some symptoms - primarily hot flashes, night sweats, and insomnia. For us, HRT can be helpful when closely monitored by our physicians. While research studies on the safety of HRT for menopausal and post-menopausal women continue, the general consensus is that the lowest does possible for the shortest period of time is the safest route for all women – menopausal and post-menopausal women included.
It’s Your Choice, So Choose Wisely
Choosing whether to use hormone replacement therapy is a highly individual decision. What works well for some women does not work well for others. What might put one woman at a higher risk for health issues might not do so for another. The key is to inform yourself with as much information as possible and balance the benefits against the risks. It is also important to discuss your options with your doctor. Once you have done that, make your decision with confidence and live well!
Sources:
Menopause Health Center: Hormone Replacement Therapy for Menopause. WebMD. Retrieved August 26, 2015. http://www.webmd.com/menopause/guide/menopause-hormone-therapy
The Experts do Agree About Hormone Therapy. The North American Menopause Society. Retrieved August 26, 2015. http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/the-experts-do-agree-about-hormone-therapy
Women’s Health Source: Estrogen, Progesterone, and Menopause. Main Line Health. Retrieved August 26, 2015. http://www.mainlinehealth.org/oth/Page.asp?pageID=OTH003601
The Pendulum Swings: Prescribing Hormone Replacement Therapy 13 Years After the Women’s Health Initiative Study. The American Council on Science and Health. Retrieved August 26, 2015. http://acsh.org/2015/08/the-pendulum-swings-prescribing-hormone-replacement-therapy-13-years-after-the-womens-health-initiative-study/
Diseases & Conditions: Hormone Therapy. Cleveland Clinic. Retrieved August 25, 2015. http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic-hormone-therapy
Reviewed August 31, 2015 by Michele Blacksberg RN