During menopause, the decline in hormones wreaks havoc on your emotional and physical well-being. The loss of estrogen can make you depressed, anxious, or both. The emotional stress you are going through is compounded by the often worse physical symptoms. As your body goes through this life change and suffers from hot flashes and insomnia, it may feel like it is too much to bear. There are many ways to manage the symptoms of menopause, the most common being Hormone Replacement Therapy (HRT). HRT is extremely effective, but it also carries serious risk, leaving many women wondering: can hormone replacement therapy be trusted? We explain everything you need to know about menopause and HRT so you can decide if you trust the treatment and want to try it.
Menopause and Hormone Replacement Therapy.
During menopause, your body’s estrogen levels drop as you lose your fertility and your menstrual period comes to an end. Falling estrogen levels cause physical symptoms that can be intense and frequent, including hot flashes, night sweats, insomnia, depression, decreased sexual libido, and depression. Hot flashes in particular can be difficult to manage and can occur without warning, often at night, where they are known as night sweats. During hot flashes, your body temperature rises, your skin turns red, and you break out in a cold sweat. The heat can be quite uncomfortable and, on rare occasions, dangerous.
Hormone replacement therapy can effectively decrease the frequency and intensity of hot flashes, as well as other symptoms of menopause, which is why so many women use it. HRT involves taking estrogen, in combination with progestin, to replace the hormones you’ve lost, level your system, and eliminate physical symptoms.
Women undergoing menopause are at increased risk of bone loss. HRT is also known to have additional benefits, such as helping to stop bone loss and helping to prevent heart disease. It’s a temporary treatment – it’s not designed for long-term use, as it could increase the risk of breast cancer, but until recently it was considered a viable treatment option. There are 2 types of HRT: systemic hormone therapy and low-dose vaginal preparation.
Recent clinical studies have brought to light troubling information regarding side effects and risks, making many doctors wary of recommending HRT. These studies linked HRT with an increased risk of certain types of cancer, especially breast and ovarian cancer, as well as an increased risk of heart attack and stroke. The results of many of these studies found that the risks outweighed the benefits, but now there have been even more studies that say the risks might be worth it, leaving many women confused and unsure. Here are the facts about HRT to help you separate fact from fiction:
The benefits of HRT:
With systemic estrogen, you can take it orally, through a patch, or through a cream, gel, or spray. It is the most effective way to combat hot flashes and night sweats. It also relieves other vaginal symptoms, including:
- dryness
- itching
- discomfort during sex
- fire
It has also been shown to help prevent osteoporosis, or bone loss, and is approved by the Food and Drug Administration to treat this condition.
Low-dose vaginal estrogen comes as a cream, tablet, or ring and is primarily for relieving vaginal symptoms and some urinary problems, such as UTIs (urinary tract infection) that often occur during menopause. This also limits the amount of estrogen your body absorbs, which limits your risk of cancer.
The risks of HRT:
Clinical studies found that HRT is associated with:
- stroke
- Cancer
- blood clots
- heart disease
Estrogen is often given with progestin to prevent the lining of the uterus from growing, as estrogen promotes its development and increases the risk of cancer. However, when a combination of these 2 drugs is taken, it can make breast tissue more dense, which can cause doctors and specialists to miss cancerous tissue. Liver disease can also arise from HRT, since systemic estrogen, when taken orally, passes through the liver. It should also be noted that these studies found that many of these risks were greater when other factors were also present, such as older age, a history of cancer or previous liver disease, and HRT was taken for a long period of time.
Can You Trust Hormone Replacement Therapy?
After all the tests and studies, doctors have determined that HRT is safe and effective when applied as follows:
- For women with no medical history of cancer or liver problems.
- For a short period of time at the onset of menopause
- For women with moderate to severe menopausal symptoms
- In women under 45 years of age
- In women suffering from bone loss