Is Menopause Hormone Replacement Therapy Right for You?
Menopause Hormone replacement therapy (HRT) is a treatment for women who have reached or passed menopause, which often is referred to as “the change of life.” HRT involves taking small doses of one or two female hormones, estrogen and progesterone.
Estrogen and progesterone are produced naturally by the ovaries until the time of menopause, when their production gradually slows down and eventually stops. Both of these hormones are necessary for the proper functioning of a woman’s reproductive system. Estrogen has many other important roles in the body as well. Some undesirable changes can accompany menopause.
Dr. Christiane Northrup, author of The Wisdom of Menopause, says there are two types of hormone replacement therapy that you could have chosen: bioidentical and synthetic. Dr. Northrup says there is some confusion as to how bioidentical hormones are created. “Bioidentical means it matches exactly the molecular structure of the hormone that your own body produces—it’s a hormone from Mother Nature. So if you get the raw material from soybeans and yams, which they do, and then you convert it into something that matches your own body’s hormone exactly, that is a bioidentical hormone,” she says.
Dr. Northrup says synthetic hormones, the more conventional approach for treatment, differ from bioidenticals in their structure. “[Synthetic hormones are] made from horse urine and are natural for a horse. But they’re synthetic for a human body. They are often added to a synthetic progestin, which doesn’t match anything like your body’s natural progesterone. It has completely different effects…Many women do well on these.”
Many women find the specifics of hormone replacement therapy confusing, and Dr. Northrup says it’s no surprise. “The mainstream medical community has flip-flopped on hormone replacement over the last five decades,” she says. “It’s good for you; it’s bad for you. It’s no wonder women are confused.”
What are the risks of hormone therapy?
In the largest clinical trial to date, the combination estrogen-progestin (Prempro) increased the risk of certain serious conditions. According to the study, over one year, 10,000 women taking estrogen plus progestin might experience:
- Seven more cases of heart disease than women taking a placebo
- Eight more cases of breast cancer than women taking a placebo
- Eight more cases of stroke than women taking a placebo
- Eighteen more cases of blood clots than women taking a placebo
- An increase in abnormal mammograms, particularly false positives
The study found no increased risk of breast cancer or heart disease among women taking estrogen without progestin. Over one year, however, 10,000 women taking estrogen alone might experience:
- Twelve more cases of stroke than women taking a placebo
- Six more cases of blood clots in the legs than women taking a placebo
- An increase in mammography abnormalities
The effect of hormone therapy on mammograms is important, because it suggests that women on hormone therapy may need more frequent mammograms and additional testing.
Who should consider hormone therapy?
Despite the health risks, estrogen is still the gold standard for treating menopausal symptoms. The absolute risk to an individual woman taking hormone therapy is quite low — possibly low enough to be acceptable to you, depending on your symptoms.
The benefits of short-term hormone therapy may outweigh the risks if you:
- Experience moderate to severe hot flashes or other menopausal symptoms
- Have lost bone mass and either aren’t able to tolerate other treatments or aren’t benefitting from other treatments
- Stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40 (premature ovarian failure)
Women who experience premature menopause or premature ovarian failure have a different set of health risks compared with women who reach menopause near the average age of about 50, including:
- A lower risk of breast cancer
- A higher risk of osteoporosis
- A higher risk of coronary heart disease (CHD)
In addition, hormone therapy appears to reduce the risk of osteoporosis and CHD when started soon after menopause in young women. For women who reach menopause prematurely, the protective benefits of hormone therapy may outweigh the risks.
Recommended Books
Natural Hormone Balance for Women: Look Younger, Feel Stronger, and Live Life with Exuberance
