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Hormone Replacement Therapy |
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Hormone Replacement Therapy (HRT) has been in the news a lot lately. What's going on? In the past, doctors prescribed hormone replacement therapy (HRT) because they hoped it could help guard against certain diesases. Doctors hoped HRT could help prevent osteoporosis, heart disease, and cancer. New information, however, suggests that for many women, the risks of using HRT may actually outweigh the benefits. What is the "Women's Health Initiative?" The Women's Health Initiative (WHI) is a set of studies conducted by the National Institutes of Health which is a division of the US Dept of Health and Human Services. Through these studies, WHI researchers are gathering information about the health of women who have gone through menopause. In the HRT trial, researchers are studying the effects of HRT on the health of postmenopausal women. Researchers were trying to determine whether using HRT affects a woman's chances of developing breast and colorectal cancers, heart disease, and osteoporosis after she has gone through menopause. Who is involved in the HRT trial? Two groups of women were involved in the HRT trial. In one group, women who had undergone a hysterectomy (surgical removal of the uterus) took either estrogen or a placebo (sugar pill). Women in the other group were also postmenopausal but they had not undergone a hysterectomy. These women took either combination HRT consisting of both estrogen and progestin or they took a placebo. The specific brand of combination medicine used in this group was Prempro. There are other brands of combination-therapy HRT, but only Prempro happened to be used in this study. I heard this study was stopped. What happened? The HRT trial was scheduled to end in 2005. However, researchers decided to stop the combination-therapy part of the study in 2002 because they could see that the risks associated with combination HRT outweighed the benefits. Specifically, it was found that long-term use (5 years or more) of combination HRT resulted in a small increase in a woman's risk of breast cancer, blood clots, heart attacks, and strokes. For each of these problems, the increased risk was about 8 more events per 10,000 women per year, compared to women who did not use HRT. What should I do if I am taking combination HRT now? If you are taking Prempro or another type of combination HRT, try not to panic. Most women will not suffer serious health problems as a result of this treatment. Visit with your doctor before making any changes to your therapy. Your doctor will consider your menopausal symptoms and your risk for developing certain diseases, then give you advise about other options or what you should do next. Some of your options may be stopping treatment altogether, taking a lower dose of medicine, or switching to another type of treatment. Are other kinds of drugs used in HRT safe? Researchers aren't 100% sure, but is is possible that women who use HRT drugs other than the ones used in the WHI study are also at higher risk of breast cancer, blood clots, heart attacks, and strokes. Even so, many doctors believe that short-term use of HRT to control menopausal symptoms is still safe for most women. Is long-term use of HRT ever a good idea? HRT still offers protection against osteoporosis, decreases the risk of colorectal cancer, and may help prevent Alzheimer's disease. If your risk for these diseases is high and your risk for diseases like breast cancer or heart disease is low, then long-term use of HRT may be an option for you. Again, you and your doctor will need to talk about your personal risk for these diseases before deciding whether long-term use of HRT is a good choice for you. Are there other options besides HRT for treating menopausal symptions and for lowering my risk of other diseases? Yes. For some women, vaginal estrogen creams, antidepressants, soy products, and certain herbal supplements offer relief from menopausal symptoms. Other medications are available to help prevent and treat osteoporosis. Your doctor can help you decide which of these treatments might be most helpful for you. Finally, remember that maintaining a healthy diet, controlling weight, exercising regularly, and not smoking can help protect against heart disease, osteoporosis, and some types of cancers. For more information on this topic, check the following links: Facts about postmenopausal hormone therapy from the National Heart, Lung, and Blood Institute Health decision guide for HRT from the Mayo Clinic. SAMA - The Right Choice in HealthCare. |
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