The year 2002 changed the way doctors -- and women -- viewed hormone replacement therapy. Hormone replacement therapy was routinely prescribed for women who developed menopausal symptoms and to diseases related to menopause such as heart disease and osteoporosis. Prescription writing slowed almost overnight when studies showed an increase in heart disease rather than the expected decrease in 2002. Doctors still prescribe estrogen therapy in some cases, but with many more caveats.
Types
Estrogen therapy is rarely prescribed alone, unless a woman has had a hysterectomy. Usually either natural or synthetic progesterone is prescribed along with estrogen, because giving progesterone and then withdrawing it induces a menstrual period. This keeps the uterine lining from becoming abnormally thick, a condition called hyperplasia that can increase the risk of uterine cancer. Estrogen comes in pill, patch or vaginal cream, ring or tablet form.
Benefits
Estrogen decreases your risk of developing osteoporosis and improves menopausal symptoms such as hot flashes, vaginal dryness, mood swings and sleep difficulties. As many as 75 percent of women experience hot flashes, which normally stop after five or six years, E.J. Mayeaux, M.D. of Louisiana State University Health Sciences Center states. Estrogen also prevents and in some cases reverses osteoporosis, particularly in the first five to seven years after the start of menopause. Estrogen may also decrease the risk of colorectal cancer.
Risks
Risks of estrogen replacement that also includes progesterone therapy include an increased risk of heart disease, breast cancer, stroke or blood clots in women taking hormone replacement therapy for five years or more. Taking estrogen without progesterone did not increase the risk of breast cancer but did increase the risk of abnormal mammogram findings, MayoClinic.com states.
Timing
The best time to take estrogen is in the first few years after menopause starts, or before age 60, MayoClinic.com states. Taking estrogen for several years helps prevent bone loss and improves symptoms in women with severe hot flashes or other symptoms. In women who develop premature menopause before age 40, estrogen does provide protection against heart disease.
Considerations
Deciding whether or not to take estrogen can be a complex decision. Women with known breast abnormalities or cancer, those with heart disease or women with a history of blood clots probably should not take estrogen, MayoClinic.com suggests. Taking the minimum amount of medications and the best delivery method for your symptoms helps minimize the risk. Vaginal creams may be most effective for treating vaginal symptoms. In some cases, a high risk for menopausal complications and a low risk of heart disease or other drug risks may make estrogen therapy right for you, if your medical practitioner agrees.
