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Menopause by Dr. Elizabeth Case

Weigh pros and cons of hormone replacement therapy

Posted: 12:00am on May 21, 2012; Modified:  1:43am on May 21, 2012

Dr. Elizabeth Case   

Menopause, often called "the change,"  affects all  women eventually.  Menopause is a term used to describe the cessation of  menses, when the ovaries stop producing hormone cycles. This signals the end of the fertile phase of a woman's life.

This time of a woman's life usually comes with a variety of troublesome symptoms that might include hot flashes, night sweats, sleeping problems, mood swings and weight gain. Exercise has been shown to greatly decrease menopausal symptoms.

Some turn to herbs (black cohash or evening primrose oil), phyto-estrogens found in some foods and acupuncture for relief.

A woman might  consider hormone  replacement therapy, or HRT, to  alleviate  menopausal symptoms.  Traditional hormone  replacement therapy  replaces the declining estrogen levels after menopause.  Progesterone also is replaced in women who have not had hysterectomies. 

Another form of HRT is bioidentical  hormones,  laboratory-made  female  hormones based on  compounds found in plants, usually soy beans or wild yams. Bioidentical  hormones are processed by a  compounding pharmacist who provides medications that have a customized  formulation to meet a  patient's specific needs. These hormones come in various forms including tablets, under-the-skin pellets, creams, gels and nasal sprays.

The decision to take HRT should not be make lightly. There are several risks and benefits that need to be considered carefully.

Advantages include:

■ Relief from hot flushes and vaginal dryness.

■ Reduced bone loss.

■ Ease of mood swings and improved sleep patterns.

■ Reduced facial hair.

■ Reduced risk of colon cancer.

■ Reduced risk of  Alzheimer's disease.

Disadvantages include:

■ Possible return of  vaginal bleeding.

■ Side effects such as breast tenderness, headaches, bloating and weight gain

■ Possible feeling of  premenstrual tension

■ More risk of breast  cancer but no known increased risk of death from breast cancer.

■ Slight increased risk of endometrial cancer unless taken with progesterone

■ Slight increased risk of gallstones

■ Increased risk of blood clots in the legs (deep vein thrombosis) that can break off and travel to the lungs (pulmonary embolism).

■ Risk of heart attack and stroke.

Menopause can be a very emotional yet manageable time. Speak to your physician to see whether HRT is the best choice for you. A well-informed patient makes the best decisions.           

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Originally Published on Monday, May 21, 2012