Is hormone replacement therapy right for you?

Life is a never-ending series of transitions, from childhood to adolescence to adulthood and beyond. And one of the most challenging transitions women face is menopause and its many symptoms such as hot flashes, night sweats, irregular periods and fat redistribution. To ease these symptoms, one of the most popular treatments is Hormone Replacement Therapy, or HRT.

What is Hormone Replacement Therapy (HRT)?

Hormone replacement therapy is just that –the use of hormones to ease menopausal symptoms. There are two general kinds of therapy: estrogen alone, or a combination of estrogen and progestin.

While estrogen is traditionally associated with the reproductive cycle, it also has a wide range of other functions in the body. Estrogen also:

• Increases blood clotting
• Increases “good” cholesterol
• Decreases “bad” cholesterol
• Improves attention and memory

Progestin is a chemical that acts like progesterone in the body. It’s added to HRT in women who still have their uterus to help counteract the risk of uterine cancer commonly associated with estrogen therapy. Like estrogen, progesterone affects more than just a woman’s reproductive cycle. Progesterone also:

• Protects brain cells from dying
• Acts as an anti-inflammatory agent
• Increases body temperature

Several large clinical trials have looked at the effects of HRT (estrogen or estrogen + progestin) over the years. One particular study of interest is the “Woman’s Health Initiative”. It followed 16,600 women over the course of five years and tried to prove that HRT was beneficial in menopausal women. Its findings were unexpected and, as a result, HRT has become less of an automatic “rite of passage” and more of a personal decision.

To help you make a more informed decision when it comes to HRT, here’s a brief summary of its benefits and risks, as well as some additional options for women who aren’t sure that HRT is right for them – but are still looking to relieve those dreaded hot flashes and night sweats.

What are the benefits of HRT?

Aside from the relief from menopausal symptoms (hot flashes, night sweats, mood swings, irregular periods and fat redistribution), the benefits of HRT are as follows:

• It helps to maintain bone health in post-menopausal women between 50-59 years of age
• It helps to delay age-related memory loss in post-menopausal women between 50-59 years of age
• It helps to prevent the risk of colorectal cancer

What are the risks of HRT?

The risks associated with HRT aren’t numerous, but they can be fairly serious. They include:

• Increased risk of breast cancer, which can be difficult to detect using a mammogram because HRT also increases the density of breast tissue
• Increased chance of developing blood clots in the legs
• Increased risk of stroke

What are the alternatives to HRT?

If you aren’t sure that HRT is right for you, here are some other options you can try:

• Regular exercise will help prevent hot flashes and counteract the loss of bone density
• A healthy diet can help prevent weight gain and decrease your risk of heart disease
• Quit smoking. Smoking will cause your menopausal symptoms to start earlier, and can cause hot flashes
• Regular supplementation: 1500 mg of calcium and 1000 IU of vitamin D per day can help with the loss of bone density
• Relaxation techniques such as deep breathing can help relieve hot flashes
• Vaginal lubricants can help with vaginal dryness
• Avoid spicy foods, caffeine and alcohol because they can cause hot flashes

Unfortunately, the use of phytoestrogens is not an effective alternative to HRT. Phytoestrogen is the plant version of estrogen. It’s commonly found in soy, red clover and alfalfa, and marketed as a “natural” form of HRT. However, clinical trials show that phytoestrogens are no more effective at relieving menopausal symptoms than a simple sugar pill.

In the early 2000s, the use of HRT was almost automatic for menopausal women. Since the discovery of its associated risks, the use of HRT has decreased – although it’s still relatively common. The decision to start HRT therapy can be very difficult for women, and depending on the severity of your symptoms, its benefits may outweigh the risks. Just remember – when it comes to your body, there is no right or wrong choice. And when it comes to menopause, hormone replacement therapy isn’t the only choice available, either.