Hormone Replacement Therapy
Consensus on hormone replacement therapy does not exist. Some (doctors and patients) believe that hormone replacement therapy not only helps to postpone menopause but also brings tangible benefits to the health of the woman. Others are willing to do anything to delay aging, to preserve the beauty and believe that the best way to achieve this – taking the hormones. They do not consider the risks associated with hormone therapy, often outweigh the benefits. Others, on the contrary, fear, suggesting that hormone therapy – is unnatural. Meanwhile hormone replacement therapy in the first place – medicine. It is appointed by prescription, has contraindications and side effects, does not allow frivolous attitude, but also cause panic should not.
What is menopause
Natural menopause, or menopause – it’s not a disease, but due to the biology stage in a woman’s life. During this period, the ovaries stop throwing eggs and female hormones (estrogen and progesterone), and menstruation ceases forever. Within a few months or years before menopause, menstruation becomes sparse and irregular, and hormone levels fluctuate. This period is called the menopausal transition.
Menopause referred to as the last independent menstruation, her date is determined, in hindsight: they say that woman is past menopause when menstruation has not been for 12 months. The age at which menopause occurs laid genetically: it is usually between the ages 51-53 years but may occur earlier (up to 45 or even 40 years).
Another menopause is artificial: because of surgical removal of the ovaries (oophorectomy) or when the ovaries stop working for other reasons (due to chemotherapy, radiation therapy, and others.). In these cases, menopause occurs at once, without perimenopause. In women who had your uterus removed (hysterectomy carried out), but retained the ovaries cease monthly, but in reality they do not go through menopause until the ovaries are functioning. , The doctor conducts blood tests for hormone levels to say for sure whether the ovaries are working.
When prescribed hormone replacement therapy
Most of the symptoms of menopause associated with a decrease in estrogen levels. hormone replacement therapy reimburses deficiency in the body and thus facilitates or eliminates the symptoms of menopause. Hormonal drugs produced in different forms:. Pills, patches, injections, vaginal creams, intrauterine devices, etc. Which one is best suited to you, determined by a physician taking into account when menstruation ceased. The selection of a hormonal drug depends on what kind of symptoms you experience, what you were sick before any operation was postponed. Also, the hormones at menopause prescribed only when they needed if other treatments are not appropriate and if there are no contraindications. Hormones are used for hot flashes and night sweats if they cause severe discomfort, incontinence and vaginal dryness that can cause sex uncomfortable, as well as osteoporosis.
Examination before hormone replacement therapy
To make sure that hormone replacement therapy is the need and that you have no contraindications, you first need to examined. The physician must measure the height and weight to determine BMI, blood pressure, determine the level of sugar, cholesterol in the blood, to appoint the general urine and blood samples. You need to reviewed by a breast physician and get a mammogram. Still, need to go for a visit to a gynecologist to do a smear on Oncocytology and ultrasound of the uterus and the ovaries. Also, check the heart – to do an electrocardiogram. Depending on your condition, and from what you hurt before, your doctor may refer you for further tests.
Based on the results you and your doctor to decide some questions:
- How appropriate use of hormone replacement therapy in your case, as it can affect the risk of cancer?
- What are the risks of other diseases that can occur due to hormonal therapy? Heart disease, stroke, thrombosis, and so on..?
- What could other drugs use to treat the symptoms of menopause and osteoporosis, instead of hormone replacement therapy?
- How severe menopause symptoms and what types and doses of hormones recommended for you?
In some cases, taking hormones at menopause is impossible. In particular, if you have had a deep vein thrombosis leg, endometrial cancer or breast cancer if you have a severe liver disease, endometriosis, uterine fibroids, elevate triglyceride levels.
Complications of hormone replacement therapy
Hormone therapy in menopause associated with an increased risk of developing particular types of cancer. The connection between hormone replacement therapy and cancer for many years studied in several major scientific studies in the US and the UK. American scientists in the framework of caring for «Women’s Health Initiative» Women’s Health (WHI) conducted two studies. The first involved more than 5,000 women in the second – more than 8500. Patients received hormone replacement therapy for 5-6 years, after which the researchers continued to monitor them for several years to track any long-term effects.
And in England conducted an observational study «Million Women Study», which counted more than a million women aged 50-64 years. Scientists collected information on the use of hormones and health of the participants and followed them for years. Part participants took estrogen alone, while others received a combination hormone replacement therapy, and some take other drugs.
Studies have shown that estrogen improves the risk of endometrial cancer. Also, the risk maintained above average even after the abolition of the hormone. And when using a combination of estrogen and progesterone increased the risk of breast cancer. And the longer a woman gets treatment, the higher the risk. But it is reduced to normal levels for three years after stopping the hormones. Also, the combined hormone therapy also associated with an increase in breast density. This complicates the detection of breast cancer on a mammogram.
Ovarian cancer – a less common type of cancer. However, a meta-analysis that connected the results of 50 studies helped to discover that women who received estrogen. And progesterone after menopause, the risk of ovarian cancer increased. But after the abolition of the hormones, it eventually decreases to normal.
In addition to cancer, hormone replacement therapy increases the risk of blood clots and gallstones.
How to reduce the risk of cancer
If you are with the doctor conclude that hormone replacement therapy. The best way to treat the symptoms or problems associated with menopause, keep in mind that this medicine. Like other drugs, hormones, it is best to use the lowest dose needed. And a very short time, which is possible. And just as if you talk any other medication, you need to be regularly seen by a doctor. The doctor will determine how well therapy, keep track of side effects. Recommend another treatment if your symptoms if necessary.