Wednesday, January 5, 2011

What Are The Risks Of Taking Hormones For Menopause?

Vivelle-dot, an estrogen patch.Image via WikipediaThe process of "reproductive aging" begins around age 40. There are declining levels of the hormones estrogen and progesterone. These hormones maintain the health of the vagina and uterus, and they regulate menstrual cycles.

Menopausal transition, called "perimenopause," is when a woman's body is close to menopause. Perimenopause usually begins about 2-4 years before the last menstrual period. It ends when menopause begins.

A woman reaches menopause when a year has passed since her last period.

Menopause symptoms include changes in periods such as intervals and flow rates, hot flashes and night sweats, vaginal dryness and thinning of bones.

To help control menopause symptoms like hot flashes, night sweats , mood swings, etc. a doctor might suggest taking estrogen and progesterone, known as hormone therapy (HT) or hormone replacement therapy (HRT). The most comprehensive evidence about taking hormones after menopause comes from the Women's Health Initiative Hormone Program sponsored by the National Heart, Lung and Blood Institute and the National Cancer Institute.

Findings of studies

The WHI Hormone Program involved two studies — the use of estrogen plus progestin (a synthetic progesterone) and the use of estrogen alone. Women who have undergone a hysterectomy are generally given estrogen alone. Women who have not undergone this surgery are given estrogen plus progestin, which have a lower risk of causing cancer of the endometrium, the lining of the uterus.

The estrogen/progestin study was stopped in 2002, when investigators reported that the overall risks outweighed the benefits. The estrogen-alone study was stopped in 2004, when the researchers concluded that estrogen alone increased the risk of stroke and blood clots.

The following are some additional findings from the WHI program about the risks of taking hormone therapy:

  • Estrogen/progestin increased the risk of breast cancer, heart disease, stroke, blood clots and urinary incontinence.
  • In women taking estrogen/progestin, the breast cancers were slightly larger and diagnosed at more advanced stages compared with breast cancers in women taking a placebo.
  • The risk of colorectal cancer and hip fractures was lower among women using estrogen/progestin.
  • Estrogen/progestin doubled the risk for developing dementia in postmenopausal women age 65 and older.
  • Endometrial cancer rates for women taking estrogen/progestin daily were the same as or possibly less than those for women taking a placebo. Uterine bleeding, however, was a common side effect, leading to more frequent biopsies and ultrasounds for women taking estrogen/progestin.
  • There may be an increased risk of ovarian cancer with use of estrogen/progestin.
  • The risk of breast cancer was decreased in women using estrogen alone.
  • Estrogen alone did not increase or decrease the risk of colorectal cancer.
  • Estrogen alone had an increased risk of urinary incontinence and a decreased risk of hip fractures.
  • Some pro's and some con's . It is important to discuss HRT with your doctor to determine whether it is right for you. As for me, I'll probably stick with my hot flash pajamas.

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    1 comment:

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