Hormone replacement therapy is done by medicines that contain female hormones that are used to replace the hormones that are of no use after menopause.
This therapy was earlier used to treat the hot flashes and other menopause symptoms and was also thought to prevent heart diseases and dementia.
Suddenly the use of hormone therapy changed when it was found that there were more health problems than benefits from this therapy especially when it was given to older women after menopause.
Hormone therapy is no longer used for the prevention pf heart diseases or memory loss. Studies have also revealed that hormone therapy can be a good choice for certain women, depending on their risk factors.
Benefits of hormone therapy
Systemic hormone therapy
Systemic estrogen comes in pill, skin patch, gel, cream or spray form.
It is the most effective treatment for relief of troublesome menopausal hot flashes and night sweats.
Estrogen helps to decrease vaginal symptoms of menopause like dryness, burning,itching, and discomfort with intercourse.
Estrogen is also approved for the prevention of the bone-thinning disease called osteoporosis.
Low-dose vaginal products
Low-dose vaginal preparations of estrogen come in cream, tablet or ring form.
They can effectively treat vaginal symptoms and some urinary symptoms.
Low-dose vaginal preparations do not help with hot flashes, or in the protection against osteoporosis like Systemic estrogen
Long-term systemic hormone therapy for the prevention of postmenopausal conditions is now outdated and no longer used.
Estrogen is prescribed with progestin for women who experience menopause naturally.
In such cases estrogen given without progesterone can increase the growth of the lining of the uterus and lead to uterine cancer. If uterus is removed progestin is not required.
Risks of hormone therapy
A Combination of estrogen-progestin pill has increased the risk of heart disease, stroke, breast cancer and blood clots including:
Hormone therapy with estrogen combined with a progestin, can make the breasts look denser and make it difficult to detect cancer in the mammogram.
With studies of different combination hormone therapies it is confirmed the therapy increases the risk of breast cancer.
The risks of hormone therapy can vary depending on several factors like
- Whether estrogen is given alone or with a progestin,
- The present age and age at menopause,
- The dose and type of estrogen,
- And other health risks like heart and blood vessel disease,
- Family medical history.
Who should be considered for it?
Systemic estrogen is still the most effective treatment for menopausal symptoms.
The benefits of hormone therapy can outweigh the risks if one is healthy and experience moderate hot flashes, have lost bone mass and have had menopause before the age of 40.
Women who have their ovaries removed at an early age and have premature menopause and are not given estrogen therapy are at a higher risk to heart problems, osteoporosis, Parkinson’s disease and dementia.
Early menopause lowers the risk of most types of breast cancer and ovarian cancer
Who should avoid it?
- Current or past history of cancer
- Ovarian cancer
- Blood clots in the legs or lungs
- Liver problem
Women are not bothered of the normal menopausal symptoms and have a menopause at the age of 45 do not need to take hormone therapy.
Risks of osteoporosis and heart diseases can be reduced by lifestyle changes and other medicines.
How to reduce the risk of hormone therapy?
One must find the best form of hormone therapy from the doctor that would be beneficial.
Estrogen in the form of a pill, patch, gel, vaginal cream, or slow-releasing suppository or ring can be placed on the vagina.
If there are only vaginal symptoms vaginal cream, ring or gel is better than pill or skin patch.
It is better to take the lowest possible dose for the shortest period of time unless one is less than 45 years.
Long term treatment can be recommended by the doctor if the woman is suffering from menopausal symptoms that are damaging the quality of life of the person.
Regular check-ups , tests and mammograms are essential to ensure the benefits of hormone therapy
Physical exercise should be a part of the daily routine when one is undergoing hormone therapy.
Healthy lifestyle changes must be made by eating a healthy diet, managing body weight, quitting smoking, limiting the intake of alcohol, managing stress and chronic health conditions like high blood pressure or high cholesterol.
Alternate methods to manage menopausal symptoms
Menopausal symptoms can be managed by leading a healthy lifestyle by keeping cool, limiting beverages and alcoholic drinks and practicing relaxation techniques. Alternate medicine like yoga and acupuncture can be effective.
We cannot ascertain that hormone therapy is not fully good or fully bad. There are several factors that can be determined by the doctor as to how far the hormone therapy is beneficial to the individual depending on the person’s symptoms and health risks.