Hormone therapy – questions and answers

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Overview

Even if information about hormone therapy are diverse and opinions are divided, hormone therapy is still an appropriate option for some women. It have been proved to be effective for treating hot flashes, night sweats, vaginal dryness and therefore it could improve sleep, mood and concentration.

However, most of the drugs included in hormone therapy shows health risks, including the risk of blood clots in the legs or lungs, stroke, breast cancer (especially in combination with estrogen and progesterone) and in older women may appear heart disease.

As such, other options such as exercise, relaxation techniques and avoiding downgraded factors (such as coffee, alcohol and spicy foods) deserves to be tried.


Contents

1. Overview
2. Questions for your doctor
3. Which are the benefits of hormone therapy?
4. Which are the risks associated with hormone therapy?
5. Who should consider hormone therapy?


Questions for your doctor

1. Do I suffer from hot flashes or night sweats (that disrupt sleep and affect the quality of life)?

If the answer is positive, hormone therapy can be a good option for you especially if you recently entered menopause. If, however, the only thing annoying is the vaginal dryness, try low-dose estrogen products to be applied locally. They do not have the same absorption system as pills and can be used safely for a longer period of time.

If you are concerned about bone health, try to get enough calcium, vitamin D and doing weight exercises for strengthening bones. Ask your doctor about the medications available to prevent osteoporosis.

2. Because of my general health status hormone therapy is too risky?

Any woman who has a history or high risk of developing breast cancer or ovarian cancer should avoid hormone therapy. The same is true for those with liver or gallbladder disease, or unexplained vaginal bleeding.

If menopause started more than ten years ago or if you have an increased risk of heart disease or stroke, hormone therapy isn’t a good choice for you. If none of these health problems are present, then you are a good candidate for hormone therapy.

3. Do you feel comfortable the idea of hormone therapy?

If and only if your symptoms and general health status suggests that hormone therapy is necessary, you should inform and take this decision. Despite society which tends to support the menopause medically, remember that there is a condition characterized by a deficiency of estrogen but rather a natural stage of life.

If you decide to try hormone therapy and risk factors are not involved, hormone therapy should not exceed two to three years and in any case not more than five years.


Which are the benefits of hormone therapy?

Women who choose hormone therapy during natural menopause (non-surgery) usually uses estrogen and progesterone. With it will improve menopausal symptoms.

Women who use estrogen for short-term relief of menopausal symptoms may gain some protection against the following conditions:

- Osteoporosis – Studies have shown that hormone therapy can prevent bone loss that occurs after menopause and decreases the risk of hip fractures associated with osteoporosis.

- Colorectal cancer – research has confirmed that hormone therapy may reduce the risk of colorectal cancer.

- Cardiovascular disease – some information suggests that estrogen may reduce the risk of cardiovascular disease in menopausal years.

For women with incipient natural menopause, estrogen and progestin are prescribed. This is explained by the fact that estrogen without progestin can increase the risk of uterine cancer. In women who experience menopause due to a hysterectomy may be recommended only estrogen.


Which are the risks associated with hormone therapy?

In general, studies have shown that it may increase the risk of serious conditions due to hormone therapy administration.

According to information obtained by researchers through a study on a sample of 10,000 with some extra use of estrogen using, were recorded:

- Over seven cases of heart disease compared to women who received placebo
- Over eight cases of cancer compared to women who used placebo
- Over eight cases of stroke compared to women who used placebo
- Over eight cases of breast cancer compared to women who received placebo
- Over eighteen cases of developing blood clots compared to women taking placebo
- Increased number of abnormal mammograms, especially those false positives.

The study found that there was any increased risk of breast cancer or heart disease among women taking estrogen without progesterone.


Who should consider hormone therapy?

Despite the health risks, estrogen is still the main therapy to treat menopausal symptoms. Most important risk for women who choose hormone therapy is quite low to be accepted by any woman, according to which symptoms she manifests.

Short-term benefits of hormone therapy may outweigh the risks if a person has:
- Severe hot flashes and other menopause symptoms
- Decreased bone mass and intolerance to other treatments
- No results were followed after other treatments
- Present premature menopause or premature ovarian failure
- Women who have premature menopause or premature ovarian failure have other risk compared to women who reach menopause at age 50 years, including:

> appears to lower risk of breast cancer
> higher risk of osteoporosis
> higher risk of coronary heart disease.

In addition, hormone therapy reduces the risk of osteoporosis and the development of blood clots that may occur soon after menopause in young women. For women who reach premature menopause hormone therapy protection benefits are greater than its risks.

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