Hormone,Replacement,Therapy,Ma health Hormone Replacement Therapy - Making the Decision

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Hormone replacement therapy (HRT) is used to alleviate the irritating effects of female menopause by replacing the estrogen which was previously produced by the ovaries. An oral dose of hormones are given to take the place of the hormones which was once produced naturally.This is a natural part of life for all women as the ovaries stop working and therefore the natural secretion of estrogen ceases. The decline and eventual cessation of estrogen secretion by the ovaries, or to be more exact, the ovarian follicles, is responsible for menopause (the change of life).When the secretion of estrogen fails, there are various effects on the body. First the monthly periods stop. Then the woman may experience hot flashes and night sweats. The woman may also experience significant discomfort as the mucous membrane of the vagina atrophies, making it dryer and thinner.Another common problem after menopause is reduction of bone density, commonly known as osteoporosis. The bones lose their density and become fragile due to the loss of estrogen.The presence of estrogen in premenopausal women appears to have the added advantage of preventing heart attacks, a common cause of death in men of similar age but this protection ceases following menopause.HRT became popular in the 1970s but went out of favour when many women on the therapy were diagnosed with endometrial cancer. It is believed that this came about as a result of the therapy being estrogen only whereas it is now usual to be estrogen with progesterone. Studies have confirmed that women taking therapy of estrogen only are more than twice as likely as women not taking the drugs to develop endometrial cancer. Several studies have shown that there is no increase in endometrial cancer or precancerous lesions in women who take both estrogen and progesterone.Menstruating women have remarkably low rates of heart disease but the incidence increases rapidly after menopause, with heart disease being the leading cause of death in women over age 60. It is believed that this demonstrates a protective role for estrogen and gives rise to the belief that HRT may give protection to postmenopausal women. However, studies into this subject tend to be inconclusive with some studies actually showing that there is a minimally higher risk of heart disease in women taking HRT.Osteoporosis is a major problem in postmenopausal women. Bone is a living substance and relies on the presence of estrogen to regenerate, thus leading to an imbalance which causes the bones to become thinner. This often results in fractures, particularly of the ribs, the vertebrae, and the hips. It can also cause chronic pain and loss of physical stature.Early studies into HRT showed a decrease of thirty-five to fifty percent in the rate of osteoporotic fractures in women who had used HRT for at least five years after menopause.HRT has customarily been given to alleviate other symptoms of menopause, such as hot flashes, vaginal dryness, low energy levels, and depression. About eighty percent of women suffer from hot flashes. These often occur at night and can result in sleep deprivation leading to chronic fatigue, depression, and poor concentration.Another problem associated with menopause is the thinning of the vaginal tissue which can cause poor vaginal lubrication, vaginal itching, pain on intercourse and an increase in urinary tract infections. Often, the use of estrogen-based creams is advised to reduce these symptoms.Many women have been reluctant to take HRT because they believe it will increase their risk of breast cancer. A 50 year old woman has 10 percent probability of developing breast cancer and a 3 percent probability of dying from it. Unfortunately, studies have shown varying results which give little evidence either way.The decision to use HRT is a personal one. The woman and her healthcare provider must consider the benefits as well as the risks in order to decide whether HRT is the appropriate treatment for the individual. If she is suffering from symptoms that are so intense that they are interfering in her day to day life, then HRT may be advisable in the short term. Often however, the symptoms will stop in time without hormonal treatment. Article Tags: Hormone Replacement Therapy, Hormone Replacement, Replacement Therapy, After Menopause, Endometrial Cancer, Studies Have, Heart Disease