Dad forwarded an article to me recently that set me on a path of learning about hormone therapy. All women should have access to this information so that they can talk to their doctors about their health.
I remember when the results of a large randomized trial called the Women’s Health Initiative were published in 2002. The results showed that hormone replacement therapy caused health risks such as a slightly raised chance of breast cancer after five years and cardiovascular disease. Some of my female colleagues and relatives were very distressed by this news. Many of them had been taking HRT to relieve the symptoms of menopause, which can be debilitating and afflict up to 80% of women in developed countries. HRT was the accepted treatment for these symptoms, and had been for decades. Within a few years the number of women receiving HRT dropped from about 20% to about 5%. Understandably, most doctors became reluctant to prescribe hormone therapy.
A new understanding of the results of the WHI has emerged in recent years, however. It turns out that the median age of women who took part in that study was 63. Many of them already had health issues such as obesity, high blood pressure and were smokers. Women who were experiencing symptoms of menopause were screened out of the trial. So a treatment that was meant for younger, healthier, symptomatic women in their 40’s and early 50’s was tested on a largely different group.
According to The Economist, a re-examination of the data showed that the women who were between the ages of 50-59 who took hormone therapy were 31% less likely to die of any cause during their five to seven years of treatment than women who did not. It turns out that hormone therapy protects bone, brain and heart health and lowers the risk of colon and uterine cancer. There is a small risk of increased incidence of breast cancer after 5 years of use, which was described as “lower than the risk of working as a flight attendant.”
For younger women who have experienced premature ovarian failure, which can be naturally occurring or as a result of medical treatments such as radiation and chemotherapy, hormone therapy is now recommended by The Society of Obstetricians and Gynecologists of Canada. It offers long-term protection for bones, hearts and brains, and eases distressing symptoms.
The Managing Menopause Clinical Practice Guideline 2014 published by the SOGC recommends that doctors offer HT in the appropriate dose, and for the duration necessary, as the most effective treatment for troubling menopause symptoms. Current research confirms that HT is both a safe and effective way to treat symptoms of menopause in women within ten years of natural menopause. There is no absolute limit for the length of time you can take HT.The Society of Obstetricians and Gynecologists of Canada
As with any medication, your healthcare provider will need to help you weigh the risks and benefits of hormone therapy. Breast cancer history, liver problems and other issues need to be taken into account, and there are certainly women who should not take this therapy. It is important to note that women with an intact uterus must take progesterone as well as estrogen, as unopposed estrogen has been linked to a higher risk of endometrial cancer.
The symptoms of menopause and premature ovarian failure include hot flushes and sweats, joint pain, cognitive issues, anxiety, and difficulty sleeping. They can interfere with work and family life, and cause suffering that may be needless.
There are many sources of information out there. I did notice in my reading that there are still websites espousing out-of-date information. My doctor recommended the resource “Menopauseandu.ca,” which has proven to be excellent.
There are a couple of articles which provide a good survey of the information in the December 12th edition of The Economist. I think you have to have a subscription to view the articles in their entirety but I will provide the links here:
The world of medicine is always evolving. We can listen to the experts and review information from studies, but I do realize that statistics only go so far. Sometimes it is very hard to know what to do when making decisions that affect one’s health. My doctor reviewed the literature and feels that I am a perfect candidate for hormone therapy. So I am giving it a try, for my bones and my heart and my brain. If it relieves my other symptoms you may hear me singing in happiness from way across town.
As always, feel free to share, dear reader. There may be a woman out there who needs to hear this information, just as I did.