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HRT | Should I Use It or Not?

From the Menopause and Hormones Articles List

Woman speaking to her doctor about whether or not to take HRT?I’ve read a lot of conflicting information about HRT. How do we decide whether or not to take it?

One of the problems with the news media is their tendency towards sensationalist headlines and their coverage of studies with all of two sentences. These can be misleading at best, but sometimes they are completely inaccurate.

There are also poorly designed studies which stumble across an odd piece of information in a group of people who are being tracked across the years. This odd piece of information is then studied from all different angles, however irrelevant it may be. Each study is like a little snapshot and it's only by putting all the snapshots together do you have a good sense of the picture. The news media announce each snapshot as if it’s the whole truth, but, that isn't the case.

A good example is osteoporosis and the pile of “snapshots” that surround it. Estrogen does prevent it if you start taking it soon after or before menopause. The most effective treatment is estrogen and a bisphosphonate. If, however, you already suffer with it (you can lose up to 50% of bone density in the first year without hormones) you will need something stronger. Everyone (on or off hormones) should take calcium and magnesium, and everyone should exercise. Osteoporosis is a serious disease, causing pain and immobility. However, not all women have the same risk of developing osteoporosis. There appears to be a genetic link; a look at your family history can tell you how hard you’ll have to work at it.

The heart situation is also a pile of snapshots right now, and most of the snapshots point to benefits. But they're trying to figure out why they don't all point to benefits. They know why estrogen would help and they also know that big population studies, of thousands of women followed across decades, have shown a clear benefit. But two major recent studies have shown real problems in the first year of use. The best guess right now seems to be that, if you already have heart disease, you should approach HRT very carefully. There is an increased risk for some women during the first year, but there is also long-term benefit. Other piles of snapshots include memory/concentration problems and libido.

What's even more frustrating and complicated is the fact that HRT studies (taking it/not taking it) don’t seem to take into account any differences between menopausal women. They lump all women into one category—menopausal. There is no way of tracking women who have been through menopause naturally and still have their ovaries, and comparing them with women without ovaries.

Women with ovaries have gone through menopause naturally and still have those ovaries conducting business on a much smaller scale (dribbling hormones) and, although of limited help, are still beneficial. It is very hard to compare no HRT/with HRT from naturally menopausal and surgically menopausal women.

Surgical menopause is just now being looked at as a different concern as the loss of ovaries tends to govern more than HRT. Adrenal glands secretion, thyroid function, hair loss/growth, energy, weight gain/loss, bone loss, heart conditions, blood concerns, and more, are areas that can deteriorate without the ovaries, thus making the replacement of HRT a hard thing to balance.

There are obviously non-hormonal alternatives, but it’s probably correct to presume that hormonal balance across the board is far more beneficial.

Discuss your feelings and concerns about hormones with your doctor. He/she can also help you sort through the risks/benefits for your particular health history.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

04-12-2003 - 03:20 PM


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