what is hormone therapy ?
- Mary OLv 61 decade agoFavorite Answer
Hormone replacement therapy: Benefits and alternatives
Hormone replacement therapy benefits some menopausal women, but there are health risks. Understand the risks associated with hormone replacement therapy, when you should or shouldn't take it, and what other treatments are available.
Until July 2002, hormone replacement therapy had been the standard therapy in the United States for treating menopausal symptoms. Not only did hormone replacement therapy relieve such discomforts as hot flashes and vaginal dryness, it also seemed to protect against several postmenopausal conditions, such as osteoporosis and heart disease.
But in July 2002, the Women's Health Initiative — a large, multitiered clinical trial sponsored by the National Institutes of Health — reported that hormone replacement therapy actually posed more health risks than benefits for women in the clinical trial. And as the number of health hazards attributed to hormone replacement therapy grew, doctors discontinued routine prescriptions for this popular treatment.
You might be wondering how this shift in opinion over hormone replacement therapy, also known as hormone therapy for menopause, affects you personally. In some cases, hormone replacement therapy is still your best option for treating menopausal symptoms. In other cases, it's wise to consider alternatives.
A turning point for hormone replacement therapy
Concerns about hormone replacement therapy stem from the results of both the combined estrogen-progestin and the estrogen-alone arms of the Women's Health Initiative (WHI) clinical trial.
Combination estrogen-progestin therapy (Prempro)
For women taking the combination estrogen-progestin used in the study (Prempro), researchers found an increased risk of:
In addition, researchers found that women taking combination estrogen-progestin experienced an increase in mammography abnormalities. The increased number of false-positives — signs of possible breast cancer that ultimately prove inaccurate — was attributed to the increased breast tissue density that estrogen induces. Women on combination therapy should be aware that they may require more frequent mammograms and additional testing as a result of this therapy.
As for quality-of-life measures, such as sleep, emotional health, general health, physical functioning and sexual satisfaction, the WHI found that for women taking combination hormone replacement therapy — most of whom didn't have troublesome menopausal symptoms — combination HRT didn't provide meaningful improvement in symptoms.
Estrogen-alone therapy (Premarin)
For women taking estrogen alone (Premarin), the WHI found no increased risk of breast cancer or heart disease, as was found with women on combination therapy, but researchers did find a slightly increased risk of stroke.
In addition, researchers found that, as with women on combination therapy, women taking estrogen alone were more likely to have abnormal mammograms than were women not on HRT. The increased number of false-positives — signs of possible breast cancer that ultimately prove inaccurate — was attributed to the increased breast tissue density that estrogen induces. Women on estrogen-alone therapy should be aware that they may require more frequent mammograms and additional testing as a result of this therapy.
Some HRT benefits still valid
Researchers did note important benefits of hormone replacement therapy in the WHI study — including a decreased risk of osteoporosis-related hip fractures and colorectal cancer. These benefits were valid for women whether they were taking combination therapy or estrogen alone.
It's all in the timing: Age is an important factor
The WHI's study population consisted of older postmenopausal women. Participants were an average age of 63 at the start of the trial. What's less certain is whether the study findings can be applied to younger women, such as women who typically start estrogen early in menopause.
A more complete analysis of data from the estrogen-alone arm of the WHI suggests there's less of a risk of heart disease if you take estrogen early in your postmenopausal years. The data analysis revealed participants age 50 to 59 who took estrogen experienced fewer heart attacks and deaths from coronary artery disease than study participants who took a placebo.
Many questions regarding younger postmenopausal women and hormone replacement therapy exist. To address some of these issues, a randomized, controlled clinical trial — the Kronos Early Estrogen Prevention Study (KEEPS) — exploring estrogen use and heart disease in younger postmenopausal women is under way, but it won't be completed for several years.
Who can benefit from hormone replacement therapy?
Despite the inherent health risks, hormone replacement therapy still has a role in treating menopausal symptoms. For some women — such as those who experience moderate to severe hot flashes or other menopausal symptoms — the benefits of short-term therapy outweigh the potential risks.
"The absolute risk to an individual woman taking hormone therapy is quite low and may be acceptable to you depending on your symptoms," says Sharonne Hayes, M.D., cardiologist and director of the Women's Heart Clinic at Mayo Clinic, Rochester, Minn. "Talk with your doctor about your personal risks."
Hormone replacement therapy might still be your treatment of choice if you have:
Hot flashes. Hormone replacement therapy is still the most effective treatment for troublesome menopausal hot flashes and night sweats.
Vaginal discomfort. Hormone replacement therapy can ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse.
Osteoporosis. Hormone replacement therapy continues to be an option for osteoporosis prevention, but it's recommended only when other medications for osteoporosis prevention have been considered and determined not to be best for you.
If you're already taking hormone replacement therapy, should you keep taking it?
If you're already taking hormone replacement therapy to relieve menopausal symptoms, review its benefits and risks with your doctor.
"Consider the reason you started hormone replacement therapy and whether the reason remains relevant," Dr. Hayes advises. "If you started hormone therapy for hot flashes several years ago, you may no longer have hot flashes and could stop taking the drug."
Your doctor may periodically advise modifications to your regimen. For example, if you're taking a particular dose of estrogen, you may be able to lower the dose. Switching from an estrogen pill to a patch may offer certain benefits. In treating isolated vaginal symptoms, estrogen in a vaginal cream, tablet or ring is usually a better choice than a pill or a skin patch. That's because estrogen applied directly to your vagina remains localized to that area to treat your symptoms and doesn't circulate throughout your body as does estrogen ingested through a pill or absorbed through a patch.
Women on hormone replacement therapy should take the lowest effective dose for the shortest amount of time needed to treat symptoms.
Who should avoid hormone replacement therapy?
Women with breast cancer or a history of blood clots should not take hormone replacement therapy. Also avoid hormone replacement therapy for preventing memory loss, heart disease, heart attacks or strokes.
Instead, talk to your doctor about other medications you can take or lifestyle changes you can make for long-term protection from these conditions.
Alternatives to hormone replacement therapy
You may be able to manage your menopausal symptoms by making healthy lifestyle choices. In fact, your doctor may recommend that you try making changes to your exercise or eating habits before you try medication. After adjustments to your lifestyle, if you're still dealing with bothersome symptoms, you have several options besides hormone replacement therapy to help relieve discomfort.
Hot flashes: Minimize discomfort during menopause
Protect your long-term health
One of the previously believed benefits of hormone replacement therapy was that it promoted long-term health of postmenopausal women, from reducing risk of heart disease to making bones stronger. But since that's no longer the case, here are some alternatives.
A healthy heart
Good-for-your-heart health tips include:
Be physically active.
Eat a low-fat, high-fiber diet, with a variety of fruits and vegetables.
Maintain a healthy weight.
Manage high blood pressure.
Keep cholesterol and triglyceride levels in check.
Avoid excess alcohol.
Keep your bones healthy and strong with:
Calcium and vitamin D. Make sure you're getting enough of these nutrients in your diet to keep your bones strong.
Exercise. Regular physical activity — especially weight-bearing exercises such as walking or dancing — can help keep your bones strong and healthy.
Medication. Certain medicines, when taken on a regular basis, can also protect your bone health. These include medicines from a class of drugs known as bisphosphonates, such as alendronate (Fosamax) and risedronate (Actonel), as well as raloxifene (Evista), teriparatide (Forteo) and calcitonin.
Heart disease prevention: 5 strategies keep your heart healthy
High blood pressure: Take steps to control it
Every situation is different
When it comes to hormone replacement therapy, no one-size-fits-all solution exists. Each woman's experience with menopause is unique.
As researchers learn more about hormone replacement therapy and other menopausal treatments, recommendations may change. Review your current treatments with your doctor on a regular basis to make sure they're still your best option.
- 1 decade ago
i don't know but your avatar is a guy and your name is Kaitlyn so apparently you need it!