Menopause and hormones

Most of us don’t think about menopause until we go through it — and then we can’t think of much else. We suffer with night sweats, hot flashes, mood swings and decreased sexual drive. (I know I’m sounding like one of those women on television saying hormone replacement therapy fixes everything.) It would be nice if there were a quick fix for these annoying issues, but you should know by now that there is seldom a perfect solution to life’s problems.

Before 2002, it was fairly common for menopausal and postmenopausal women to take estrogen and progesterone to reduce hot flashes and night sweats. But after a large study involving more than 16,000 women found the risks of hormone replacement therapy (HRT) outweighed the benefits, doctors quit prescribing HRT routinely. The Women’s Health Initiative, a 15-year research study established by the National Institutes of Health, found that HRT was associated with increased risk for breast cancer, stroke, heart attacks and blood clots.

After my sister was diagnosed with advanced breast cancer, I found it especially alarming to learn that using hormone replacement therapy can make breast cancer harder to find. According to the Mayo Clinic’s website, “Hormone therapy, particularly estrogen combined with a progestin, can make your breasts look more dense on mammograms, making breast cancer more difficult to detect.” 

All that said, hormone replacement therapy does have benefits. HRT can reduce or eliminate many of the symptoms of menopause. Hormone replacement therapy may also reduce the risk of colorectal cancer and osteoporosis. And a recent Danish study found that women who took estrogen alone shortly after beginning menopause were less likely to develop heart disease and did not have an increased risk of cancer or stroke. 

What about so-called bioidentical hormones? Are they safer? The American Cancer Society states on its website that no studies have shown that bioidentical hormones are any safer than other hormones.

The question of whether or not to use hormone replacement therapy does not have a short or easy answer. The guideline most doctors use today is to prescribe the lowest effective dose for the shortest amount of time needed to treat the symptoms. Talk with your doctor. Weigh the pros and cons and make an informed decision.

For more information, check out the Food and Drug Administration’s website for its take on this topic: http://www.fda.gov/ForConsumers/ByAudience/ForWomen/ucm118624.htm.