Marriage Matters

Hormone Replacement Therapy – Should I or Shouldn’t I?

Women in their mid-40s become increasing aware that menopause is just around the corner. As their fertility wanes, women begin to pay attention to any information about minimizing hot flashes, improving sleep patterns or preventing weight gain. No woman wants to experience any of these undesirable symptoms and many women will do whatever they can to avoid them.

Perhaps that is why the thought of hormone replacement therapy (HRT) is so attractive. It used to be routinely prescribed for menopausal women because it did reduce or eliminate most of the adverse symptoms associated with the loss of fertility. But, in 2007, the results of a large Women’s Health Study showed that HRT posed more health risks than benefits. Since that time, doctors have been cautious about prescribing the drug for any patients.

A recent article published in the October Journal of the American Medical Association (JAMA) has taken another look at the data from the WHI data as well as other statistics since 2007. This extended analysis has once again shown that “the health risks associated with long-term hormone replacement therapy outweigh the benefits…” (Medscape Medical News. 10/1/13)
Here are some of the results highlighted in the article.

Women who took either conjugated equine estrogens (CEE) or medroxyprogesterone (MPA) were 80% more likely to develop coronary heart disease at year one than women receiving a placebo. And women in the CEE + MPA group were 24% more likely to develop breast cancer than women in the placebo group. The same article also reported that women in the control groups did have a modest reduction in menopausal symptoms.
The data seems to be convincing that HRT can moderate the common indications of menopause but at the potentially high threat of breast cancer and cardiovascular disease. This report suggests that women should proceed cautiously with the use of HRT because of the complex profile of risks and benefits. 

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