Up until recently, Hormone Replacement Therapy (HRT) was considered the best treatment option for women undergoing menopause. It was widely prescribed by doctors to treat a variety of menopause symptoms but that all changed when some troubling evidence about HRT began to emerge. In 2002, the US government put a stop to a drug trial conducted by the Women's Health Initiative (WHI) regarding the use of hormone replacement therapy. During this testing, it was found that HRT caused an increase in many diseases and disorders such as breast cancer, blood clots, strokes, endometrial cancer, and heart disease. The results were so dramatically negative that HRT fell out of favor and women no longer felt safe taking them.
Although the view of HRT became negative due to the Women's Health Initiative study, this does not give a complete picture of HRT. Another study being conducted at the same time as the WHI study found some problems with the WHI study and left more questions than it answered. Because the WHI group studied women 50 - 79 years old with an average age of 63 years old this study most likely reflects the long term use of estrogen and is not a reflection on short term HRT use. The WHI study also consisted of women who were more overweight than the US population as a whole so they would have been more susceptible to cardiovascular problems even without the use of HRT so this also skews the results.
The study by WISDOM (Women's International Study of Long Duration Estrogen after Menopause) started in the 1990's was closed down as a result of the negative results of WHI study but before it was, it was breaking down HRT by age group and long term usage and was getting better results regarding HRT. Also WISDOM was looking at the long term use of estrogen alone as well as combined HRT which has both estrogen and progesterone. Since the WISDOM study was never officially concluded no positive conclusions can be drawn from this study but two questions left still unanswered by either study are 1) Can HRT be used successfully short term at the start of menopause? 2) Will different types of HRT treatments have the same negative results?.
Risks associated with HRT:
• Breast cancer
• Endometrial Cancer
• Deep vein thrombosis
• Pulmonary embolism
• Strokes
• Heart Attacks
• Tinnitus
• Autoimmune disease complications
Obviously with so many risk factors, HRT is no longer as popular as it once was. It's still being prescribed today but usually only for short usage of one to two years for natural menopause. For women undergoing surgical menopause HRT may be used for a longer duration, perhaps even until natural menopause occurs.
Unfortunately, not a lot of test data is available on the various types of HRT currently available. Most of the clinical trials have been on conjugated equine estrogens (CEE) so most of the side effects attributed to HRT are related to these CEE medications. Bioidentical human estrogen has yet to be studied extensively and the negative results of CEE can not be applied to bioidentical human estrogen and other hormone treatments becoming available. Since bioidentical human estrogen is becoming increasingly popular more testing needs to be done so that women can make informed choices.
If you have any question about HRT, be sure to go over them with your doctor and if you have a family history of any of the diseases that may be aggravated by HRT, make sure to tell your doctor. When it comes to your health and getting through menopause safe and sane, do your research and explore all your options.
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