1. It's Not for Every Woman
Menopause begins when a woman's ovaries decrease the production of estrogen and progesterone hormones, which ends her ability to have a period and reproduce. Prior to 2002, doctors prescribed hormone replacement therapy (HRT) for women with menopausal symptoms to help balance the low estrogen and progesterone hormones in their bodies. These symptoms often include hot flashes, urinary problems, mood swings and vaginal dryness. In 2002, researchers found that HRT increased some health risks for menopausal women, and was not worth the benefits it provided. As a result of this large clinical trial, known as the Women's Health Initiative (WHI), doctors became less likely to prescribe it.
2. Estrogen vs. Combination Therapy
Menopausal women should talk with their doctor to determine if HRT is right for them. Some women may not be eligible for HRT. Individuals with a history of blood clots, breast cancer or heart disease should not be doing HRT. Alternative treatments may be available. Some women may receive estrogen-only hormones, where a low dose is prescribed as a pill, patch or cream. Or some may receive combination therapy, receiving both estrogen and progesterone hormones.
3. Increased Health Risks From HRT
The Women's Health Initiative found that women taking the combination estrogen-progestin (Prempro) used in the study had an increased risk of developing certain serious conditions, such as heart disease, breast cancer, stroke and blood clots. Other HRT risks include increased risk for endometrial cancer. Side effects may include monthly bleeding, irregular spotting, breast tenderness, fluid retention, headaches, dizziness, skin discoloration (brown or black patches) and irritation, and increased breast density that makes mammogram interpretation more difficult.
4. Estrogen Is Still the Most Effective Treatment
Estrogen remains the most effective treatment for relief of troublesome menopausal hot flashes and night sweats. Other benefits of HRT are the easing of vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse; and increased prevention of osteoporosis. Long-term HRT for the prevention of postmenopausal conditions is no longer routinely recommended. But women who take estrogen for short-term relief of menopausal symptoms may gain some protection against osteoporosis, colorectal cancer and heart disease.
5. Keep Getting Mammograms and Breast Self-Examinations
Menopausal women should continue to be proactive with all areas of their health, including leading a stress-free life, increasing their diet with lean meats and fruits and vegetables, increasing their daily activities and they should keep getting mammograms and breast self-examinations. Women who take estrogen or combination therapy may need more frequent mammograms and additional testing.
