Copyright 2006 Anne Wolski
Hormone replacement therapy (HRT) is used to alleviate the
irritating effects of female menopause by replacing the estrogen
which was previously produced by the ovaries. An oral dose of
hormones are given to take the place of the hormones which was
once produced naturally.
This is a natural part of life for all women as the ovaries stop
working and therefore the natural secretion of estrogen ceases.
The decline and eventual cessation of estrogen secretion by the
ovaries, or to be more exact, the ovarian follicles, is
responsible for menopause (the change of life).
When the secretion of estrogen fails, there are various effects
on the body. First the monthly periods stop. Then the woman may
experience hot flashes and night sweats. The woman may also
experience significant discomfort as the mucous membrane of the
vagina atrophies, making it dryer and thinner.
Another common problem after menopause is reduction of bone
density, commonly known as osteoporosis. The bones lose their
density and become fragile due to the loss of estrogen.
The presence of estrogen in premenopausal women appears to have
the added advantage of preventing heart attacks, a common cause
of death in men of similar age but this protection ceases
following menopause.
HRT became popular in the 1970s but went out of favour when many
women on the therapy were diagnosed with endometrial cancer. It
is believed that this came about as a result of the therapy
being estrogen only whereas it is now usual to be estrogen with
progesterone. Studies have confirmed that women taking therapy
of estrogen only are more than twice as likely as women not
taking the drugs to develop endometrial cancer. Several studies
have shown that there is no increase in endometrial cancer or
precancerous lesions in women who take both estrogen and
progesterone.
Menstruating women have remarkably low rates of heart disease
but the incidence increases rapidly after menopause, with heart
disease being the leading cause of death in women over age 60.
It is believed that this demonstrates a protective role for
estrogen and gives rise to the belief that HRT may give
protection to postmenopausal women. However, studies into this
subject tend to be inconclusive with some studies actually
showing that there is a minimally higher risk of heart disease
in women taking HRT.
Osteoporosis is a major problem in postmenopausal women. Bone is
a living substance and relies on the presence of estrogen to
regenerate, thus leading to an imbalance which causes the bones
to become thinner. This often results in fractures, particularly
of the ribs, the vertebrae, and the hips. It can also cause
chronic pain and loss of physical stature.
Early studies into HRT showed a decrease of thirty-five to fifty
percent in the rate of osteoporotic fractures in women who had
used HRT for at least five years after menopause.
HRT has customarily been given to alleviate other symptoms of
menopause, such as hot flashes, vaginal dryness, low energy
levels, and depression. About eighty percent of women suffer
from hot flashes. These often occur at night and can result in
sleep deprivation leading to chronic fatigue, depression, and
poor concentration.
Another problem associated with menopause is the thinning of the
vaginal tissue which can cause poor vaginal lubrication, vaginal
itching, pain on intercourse and an increase in urinary tract
infections. Often, the use of estrogen-based creams is advised
to reduce these symptoms.
Many women have been reluctant to take HRT because they believe
it will increase their risk of breast cancer. A 50 year old
woman has 10 percent probability of developing breast cancer and
a 3 percent probability of dying from it. Unfortunately, studies
have shown varying results which give little evidence either way.
The decision to use HRT is a personal one. The woman and her
healthcare provider must consider the benefits as well as the
risks in order to decide whether HRT is the appropriate
treatment for the individual. If she is suffering from symptoms
that are so intense that they are interfering in her day to day
life, then HRT may be advisable in the short term. Often
however, the symptoms will stop in time without hormonal
treatment.
About the author:
Anne Wolski has worked in the health and welfare industry for
more than 30 years. She is a co-director of
http://www.magnetic-health-online.com an information portal with
many interesting medical articles and also of
http://www.pharmacybyweb.com which has online physicians who can
help you with any questions you may have.
