Before, during, and after menopause, women are faced with an onset of symptoms that sometimes have them flying blind in terms of treatment. The influx of information about hormones, aging, natural therapies, and more is sometimes just too much to handle. Over the years, doctors have recommended hormone replacement therapy (HRT) for the treatment of symptoms associated with menopause. There have been some controversies, however, surrounding hormone replacement therapy and whether it is an appropriate treatment for menopause.
WHAT IS HORMONE REPLACEMENT THERAPY?
Hormone replacement therapy, sometimes called “endocrine optimiztaion,” is a treatment that is used to supplement natural hormone levels in the body. This is usually in two forms, either in estrogen-alone therapy (ET) or as estrogen with progesterone therapy (EPT). The former is for women who had a hysterectomy (otherwise known as the surgical menopause), while the later is for those women who experience menopause in their midlife naturally.
Estrogen serves many functions apart from the reproductive function of thickening the lining of the uterus to prepare it for egg implantation. Some of the functions include aiding the body to process calcium, helping the body to maintain healthy cholesterol levels, and keeping the vagina healthy. However, once menopause starts to set in, the amount of natural estrogen and progesterone produced by the ovaries drops significantly. This is usually followed by symptoms such as hot flashes, vaginal dryness, night sweats, painful intercourse, sleep problems, and mood changes. It can also increase the risk of osteoporosis. Hormone replacement therapy can help replenish the body’s estrogen to relieve the symptoms of menopause, prevent osteoporosis, and reduce the risk of heart disease.
TYPES OF HORMONE REPLACEMENT THERAPY
It is important to note that women who undergo surgical menopause (hysterectomy), estrogen alone is generally prescribed. For women with a uterus, the combination of estrogen and progesterone is prescribed. The reason for this is that it may be risky to take estrogen alone for women who are undergoing menopause naturally, as this can lead to cancer of the endometrial lining. However, adding a synthetic version of progesterone through hormone replacement therapy reduces the risk of endometrial cancer by causing the lining to shed every month.
Synthetic and more natural options are also available.
Bio-Identical Hormones are generally more effective and safer than synthetic hormones because they are:
- Derived naturally
Because Bio-identical Hormones (testosterone, estrogen, and progesterone) are derived from natural sources, our bodies can metabolize them more efficiently. Bio-identical hormone regimens are also customizable, which means that they can be modified to your specific health profile and your individual hormonal needs. Unlike synthetic hormones, which are formulated with a one-size-fits-all approach, bio-identical hormone replacement allows for a more tailor-fit hormonal regimen that is best for you.
THE “DANGERS” OF HORMONE REPLACEMENT THERAPY
Many of the rumors and circulating information about the dangers of HRT have been highly misleading. A Women’s Health Initiative clinical trial in 2002 is the study that many people, physicians included, have based their negative opinions about HRT. While it was indicated in that the WHI stopped the trial because HRT caused breast cancer and heart attacks, the reality was that the study was stopped for “more subtle reasons and there was no statistically significant harm for either breast cancer or heart attacks” (Science Daily). The unfortunate result was that the paper misrepresented the findings, and made inflammatory claims that were not supported by the data when viewed according to the pre-established study protocol — which was largely abandoned in this and subsequent reports (read more about this here).
Professor Mary Ann Lumsden, the International Menopausal Society President comments: “All clinicians constantly reappraise treatment modalities and look at the balance of risk, but now is time for us to recognise that hormone therapy prescribed to healthy postmenopausal women within 10 years of their last menstrual period, is an effective intervention, and for most women benefits outweigh risks. It can help avoid the many symptoms women suffer during this transitional period of their lives. We welcome the release of this paper, which reinforces the advice provided in our evidence based IMS Recommendations on HRT.”
WHEN SHOULD YOU CONSIDER HORMONE REPLACEMENT THERAPY?
Candidates for hormone replacement therapy are women with moderate to severe symptoms of menopause. However, those who have a family history of osteoporosis should also consider HRT because of the help it gives the body to absorb calcium
Usually, the late forties to mid-fifties is the age that most women experience the onset of menopause, and the most severe symptoms last for two to three years. There are no special rules about when a woman reaches menopause or how long the symptoms may last. Therefore, women of many ages are prescribed HRT. Doctors recommend taking a low-dose treatment which is the most effective way to get the benefits of HRT while limiting the negative effects.
HRT may not be a cure-all method, and it is best to work closely with your doctor to monitor your health and symptoms very closely as you commence your treatment, but it remains the best method of treating severe cases of the unpleasant and sometimes debilitating symptoms of menopause and improving the quality of life.
Contact a Revitalogy Physician today to learn more about whether HRT is right for you.
Or, call to schedule an appointment today: 561.406.2269