Hormone Replacement Therapy: What Do the Latest Findings Mean?
Menopause, the time in a woman’s life when her monthly period stops, is a normal part of aging. In the years before and during menopause, the levels of female hormones can go up and down, according to Francine Siegel, M.D., an obstetrician/gynecologist on staff at Lourdes Medical Center of Burlington County. “This can cause symptoms such as hot flashes and vaginal dryness.
“For decades, women have used hormone replacement therapy (HRT) to ease symptoms of menopause, such as hot flashes and sleeplessness, and to protect against osteoporosis,” Dr. Siegel said. Some women took HRT to obtain long-term health benefits, such as heart disease protection.
However, HRT also has risks, and each woman’s individual risks can vary depending upon her health history and lifestyle.
Understand the Risks
In 2002, results of the Women’s Health Initiative study, a large clinical trial sponsored by the National Institutes of Health, seemed to show that hormone replacement therapy could have life-threatening risks such as heart attack, stroke and cancer for some women. Physicians no longer routinely prescribe hormones for each and every woman as a normal course of treatment during menopause. A large number of women who took HRT for its protective benefits only, not for the relief of menopausal symptoms, were advised to stop taking it.
Find Expert Advice
“Hormone therapy is a field that continues to change rapidly,” said Dr. Siegel. “Treatment is more individualized than ever. Women are seeking the one right answer, but in medicine, there is no â€˜one size fits all.'” Certainly, if you have a family or personal history of heart disease, stroke, blood clots or breast cancer, you need to carefully consider those risk factors when making your decisions. If you are healthy and have a family history of osteoporosis or colon cancer along with severe menopausal symptoms, HRT may be beneficial. As with all types of medications, it should be the lowest dose that helps and for the shortest time needed. Taking hormones should be re-evaluated every six months.
If you’re concerned about HRT, talk to your doctor, advises Dr. Siegel. Together, you can evaluate your own health history and individual risk factors.
Evaluate other coping strategies
If you and your doctor decide that HRT is not right for you, various options exist. For instance, simple lifestyle strategies and holistic methods often can ease the following menopause symptoms:
- Hot flashes: Avoid possible dietary triggers, such as spicy foods, alcohol and caffeine. Add tofu, soy milk and other soy products to your diet.
- Mood changes: Exercise and stress-reduction techniques, such as yoga and imagery, may improve mood swings.
- Urinary incontinence: Simple Kegel exercises, which involve squeezing and releasing the muscles that control urine flow, can help.
- Sleeplessness: Exercise regularly.
- Vaginal dryness: Use natural moisturizers, such as vitamin E oil, sesame oil and olive oil. Or try over-the counter water-based gels.
What about heart health and protection against osteoporosis? In addition to lifestyle strategies, such as a healthy diet and regular weight-bearing exercise, other medications exist that can help you manage these risks. Check with the doctor to see if you would benefit. In addition, some women have taken herbal supplements to relieve menopausal symptoms, although there is no scientific evidence that they are effective. Be sure to tell your doctor if you use herbal supplements, as they may affect other medications you are taking.