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Are you post menopausal and suffering from unbearable hot flashes or mood swings? Treatments for symptoms are available. Hormone replacement therapy (HRT) helps to the body replace hormones it no longer produces.
But HRT has been controversial for many years. How long can post menopausal women safely take them to reduce their symptoms?
Read further for information on the latest findings.
Are You Post Menopausal?
The average age of menopause is 51 years. However, women who smoke often go through menopause earlier than nonsmokers. The average life expectancy for women in the U.S. is 84 years. This means that they spend about 50% of their adult lives in postmenopause.
A woman is post menopausal when she's had an entire year without her period. It brings on many unpleasant symptoms. Most improve by themselves within 2-5 years after your last period. But some women experience symptoms up to 10 years.
The symptoms of menopause and post menopause can be extremely uncomfortable. They include:
- Hot flashes and night sweats
- A change in the length and flow of your periods
- Vaginal dryness
- Mood swings
- Lack of concentration
- Hair loss or more hair on the face
Hot flashes are the most troubling symptom when a woman is post menopausal. 75% of women have hot flashes. They are more severe in African-American women and smokers. Suddenly feeling overheated and sweaty drives many women to think about HRT.
What Is HRT?
As you reach menopause and post menopause, you may give more serious thought to learning about HRT. It's an important consideration in every woman's life. When you do reach menopause, will HRT be right for you?
As little as 10 years ago, every woman who reached menopause without fail got a prescription for HRT. It was the standard treatment to relieve post menopausal symptoms.
HRT is an approved therapy for post menopausal symptoms. It can also prevent osteoporosis. Reduced levels of estrogen cause the symptoms that many women experience.
There are two types of HRT:
- Estrogen-only therapy (ET). Estrogen provides the most help with post menopausal symptoms. It is also prescribed for women who had a hysterectomy.
- Estrogen plus progestogen therapy (EPT). Progestogen protects women who haven't had a hysterectomy from cancer.
Ways to take HRT:
- Systemic - They circulate through the blood and every part of the body. They come in oral tablets, gels, emulsions, patches, sprays, or injections. Systemic HRTs provide relief for hot flashes, vaginal dryness, and osteoporosis.
- Non-systemic - They affect a specific area of the body. They come as rings, creams, or tablets for vaginal symptoms.
There are no set guidelines on how to prescribe HRT's. Physicians recommend an individual plan for each woman. There is no 'one size fits all' treatment.
Bioidentical means these hormones are the same as those that your body makes. They also may not be any different from those in traditional HRT.
Bioidentical hormones originate from plant or animal sources and are not made in a lab. Yet many of these products need to be commercially processed.
There are claims that bioidentical hormones have benefits that traditional HRT's don't. They differ in doses and forms when compared to FDA-approved HRT's. Some women improve with non-standard doses and forms of hormones in bioidentical hormones.
Also, they custom-make them for each individual by testing hormone levels in saliva. The hormone levels in saliva are not the same as in your blood.
Opponents argue that there are no quality control standards when making these products. Unfortunately, there is also not any data that confirms any of these advantages. Pros and Cons
- 37% less risk of colorectal cancer
- 37% fewer hip fractures from reduction of osteoporosis
- Increased blood flow through the body
- Improvement of post menopausal symptoms such as hot flashes and mood swings
- Possible decrease in Alzheimer's cases
- Possible decrease in blood sugar levels
Risks of HRT include:
- Increase in endometrial cancer when women take only estrogen.
- Increase in breast cancer if using long-term
- Increase in cardiovascular disease
- Increase in lab results for inflammation, such as C-reactive protein (CRP)
- Increase in blood clots and stroke, especially in the first year
Evidence of Risks and Benefits
Many women reconsidered taking HRT due to recent studies on the long-term use of HRT. The Heart and Estrogen-Progestin Replacement Study (HERS) found in the first year of HRT there was a 50% increase in heart attack and stroke. But, after two years of HRT, they had a decrease in these diseases.
The Women's Health Initiative (WHI) performed a larger study. It's the largest study that examined the effects and risks of HRT in menopausal women.
In 2002, the WHI stopped giving women both estrogen and progestin therapy. Data from this group found an increased risk of heart disease, breast cancer, stroke and blood clots in the lungs and legs.
In 2004, they ended the group taking only estrogen because results indicated an increased risk of blood clots, stroke, and heart attack.
Due to these studies, they created new guidelines for prescribing HRT. These include:
- Stopping the use of HRT as a prevention of heart attack or stroke.
- Weigh the pros and cons of using HRT for prevention of osteoporosis
- Women with pre-existing heart disease should think about other options.
- Use in only the short-term for menopausal symptoms.
- Discourage long-term use
How Long Can HRT Be Safely Used?
For many years, women dealt with conflicting data on the risks and benefits of HRT. A new clinical trial studied women for about 18 years and has conclusive data that the worry and grim outlook for HRT are not justified.
They found that women who took some type of HRT for six to seven years didn't have an increase in death when compared to placebo. They didn't have increases in heart attack, stroke, or cancer.
HRT taken by menopausal women for five to seven years does not carry an increased risk of long-term complications.
What Can You Do About Your Symptoms
There are two approaches to treat symptoms. They are medical and behavioral.
- HRT is the best treatment for hot flashes
- Anti-depressants known as selective-serotonin reuptake inhibitors (SSRIs) are another option if you don't want to take HRT
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) and gabapentin treat hot flashes
If HRT is not right for you, there are alternative treatments you can try. These include yoga, mindfulness meditations, hypnosis, or exercise and weight loss. Talking to a therapist trained in cognitive behavioral therapy (CBT) is another option.
Keep in mind that everyone is different. Hang in there and don't get frustrated if the first treatment doesn't help. You may have to experiment a bit to find the right treatment for you. It may take a combination of HRT and alternative therapies to get relief from symptoms.
How We Can Help
Medical providers have changed their views about HRT. There is a great deal of information to discover. The studies already done don't address all of the issues that women face.
Women have many issues to address before deciding to use HRT. These include risks, age, preferences, options available, and the cost of the treatment.
Questions for your doctor include:
- Do the potential benefits outweigh the potential risks?
- Is this the right choice for treatment?
- Are there better or safer option?
- What is the side effect profile?
- Will HRT completely resolve the symptoms?
Once you evaluate and understanding your situation, you can make an educated decision. Make sure to talk to your doctor and ask as many questions as you need. Re-evaluation of the treatment options may change as new therapies become available and as you age.
Now is the time to treat yourself and learn what your body needs. Maintain a healthy lifestyle through healthy foods, exercise, and good sleep. Do what feels good for your body. Enjoy feeling comfortable within your body when your menopausal symptoms disappear with HRT.
If your goal is to reduce your risk of future health issues or maintain your quality of life, there are a variety of treatments to choose from. Have a discussion with your doctor and weigh all your options.
Information about HRT is consistently evolving. As new information is discovered through research, your options increase.
The bottom line is that you don't need to suffer in silence. Seek help if you feel you need it. Keep an open dialogue with your physician about your experiences and possible the need to change your treatment.
Check out many of the issues women face when going through menopause.
Published: May 04, 2018
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