Hormone Replacement TherapyheadingContent

Posted on June 24, 2015

4 women looking at a digital camera at an eventHormone Replacement Therapy (HRT) is a safe option for many menopausal women who have significant hot flashes. Not all women are candidates for HRT, but the majority of women are excellent candidates.

What are the reasons for Hormone Replacement Therapy?
Nowadays, HRT is only given for hot flashes and other menopausal symptoms such as night sweats, mood changes and significant vaginal dryness. HRT is also sometimes given for sexual dysfunction symptoms, in addition to sexual cognitive therapy.  Women with severe symptoms often suffer in relationships and employment because the symptoms often interfere with functioning, sleep and mood.

Who is a candidate for Hormone Replacement Therapy?woman yelling at a fan
Good candidates are usually young, newly menopausal women who have severe symptoms and who have no contraindications to therapy, such as breast cancer, uterine cancer, cardiovascular disease and history of blood clots.

I do see patients with the above conditions who do take the HRT because their symptoms are very severe; this is a personal decision where the risks versus benefits are carefully weighed.

What are the risks?
The risks of HRT are very small, especially with short term use. The risk of breast cancer increases slightly with HRT but interestingly, this is not the case in women who have had a hysterectomy. Also, in patients diagnosed with breast cancer, the risk of mortality from breast cancer does not increase.  Risks of blood clots do increase slightly. Overall, life expectancy studies do not show significant reduction due to HRT.

Is Bio-identical Hormone Replacement Therapy better?
The answer is an unequivocal no. American College of Obstetrics and Gynecology, North American Menopause Society and The Endocrine Society are national organizations which have specifically warned against bio-identical product’s use because of quality control and financial incentives which are considered a conflict of interest. The testing, such as saliva testing, has been scientifically proven to be unnecessary and inaccurate.

In conclusion, hormone replacement therapy has helped millions of women function better in their lives and should not be feared.