Saturday, February, 11, 2012

Hormone Replacement Therapy (HRT)

Table of Contents

  • Hot flashes
  • Night sweats
  • Sleep difficulties
  • Vaginal dryness
  • Anxiety

Usually, hot flashes and night sweats are less severe after a couple of years, especially if hormone therapy is slowly reduced.

A woman's body produces less estrogen during and after menopause, which may affect her bone strength. Hormone therapy may also prevent the development of osteoporosis. For information on treating bone loss, see: Osteoporosis.

Studies have not been able to clearly show that hormone therapy helps with urinary incontinence, Alzheimer's disease, or dementia.

RISKS OF HORMONE THERAPY

BLOOD CLOTS

Doctors have long known that taking estrogen increases a person's risk for blood clots. Generally, this risk is higher if you use birth control pills, which contain high doses of estrogen. Your risk is even higher if you smoke and take estrogen. The risk is not as high when estrogen skin patches (transdermal estrogen) are used.

CANCER

Breast cancer: Woman who take estrogen therapy for a long period of time have a small increase in risk for breast cancer. Most guidelines currently consider hormone therapy safe for breast cancer risk when taken for up to 5 years.

Endometrial/uterine cancer: The risk for endometrial cancer is more than five times higher in women who take estrogen therapy alone, compared with those who do not. However, taking progesterone with estrogen seems to protect against this cancer. Endometrial cancer does not develop in women who do not have a uterus.

CARDIOVASCULAR DISEASE

Heart disease: Estrogen may increase the risk of heart disease in older women, or in women who began estrogen use more than 10 years after their last period. Estrogen is probably the safest when started in women under age 60, or within 10 years after the start of menopause.

Deep venous thrombosis (DVT or blood clot in a vein) and pulmonary embolus (PE or blood clot in the lungs) are more common in women who take oral estrogen, regardless of their age.

Stroke: Women who take estrogen have an increased risk for stroke.

Women who also smoke, have heart disease, or are at higher risk for heart disease and stroke are less likely to be given estrogen hormones.

GALLBLADDER DISEASE

Several studies have shown that women who take estrogen/progestin therapy have an increased risk for developing gallstones.

SIDE EFFECTS OF HORMONE THERAPY

As with all medicines, side effects are possible. Some women taking hormone therapy may have:

Images

Uterus

Review Date: 09/11/2010
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)