“The risks of breast cancer, stroke, heart attack and blood clots outweigh the benefits for bones. And we have other drugs we can use to prevent osteoporosis.”-Dr. Jerry Avorn, associate professor of medicine at Harvard Medical School
There are several symptoms that signal the onset of menopause in women. Most women suffer from vaginal hot flashes, severe mood swings and itchiness or dryness. These irritating conditions are relieved by a treatment called hormone replacement therapy, also called hormone therapy for women. It has been a very popular and preferred treatment for uncomfortable menopausal symptoms. With natural menopause, the monthly cycles stop. The amount of hormones (progesterone and oestrogen) produced by the ovaries of a woman reduces significantly. Also, hormone replacement therapy is used in treating surgically menopausal women. The ovaries are removed by surgery for various reasons, hence the term ‘surgical menopause’.
Action of HRT
What hormone replacement therapy does is to provide the body with these hormones in order to reduce the postmenopausal symptoms that many women suffer from. There may be a slight risk in supplying just one of these two hormones. For example, for women with intact uterus, being given oestrogen might have a greater risk of endometric cancer. Of course, the amount of replacement hormones is less than what the ovaries normally produce in reproductive women. At a time, the replacement may not have many risks, but regular replacement of hormones might expose these women to slightly higher risk of strokes, cancer and fractures.
Benefits of HRT
With a balanced replacement therapy, there are hardly any risks. In fact, HRT is very helpful for preventing osteoporosis in postmenopausal women. Age also needs to be considered; women above the age of 60 might not benefit too much from HRT but relatively younger women in their 50s usually respond very well to HRT. Irritating menopausal discomfort reduces greatly. The chances of getting rectal and colon cancer are also reduced. On the whole, HRT is found to be quite useful, since the hormones are important for several tissues. It is a common fear that HRT increases chances of getting breast cancer, but actual studies dismiss the assumption.
HRT prescription
The dosages and the form of hormone supply vary with patient’s needs. There are creams, patches, injections and tablets for hormone replacement. There is no common dosage for all women. Similarly, the effect of HRT may differ slightly for different individuals. Doctors strive to get the most suitable combinations for treating individual women. The treatment may be for short term (up to 5 years) or long term in some cases. Women undergoing HRT are advised to take pap tests and mammograms. If needed, testosterone may also be administered in suitable quantity. It is better to clarify doubts and notify the doctor about any health conditions before taking HRT.
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