Hormone replacement therapy is simply a means of
"replacing" estrogen back to the pre-menopausal levels in order
to provide relief from the symptoms described above and also decrease the
risks of heart disease and osteoporosis. The risks of estrogen replacement
are often sensationalized in the press, so that women are unsure of the
decision to use this therapy. One risk which has been known for some time
is for endometrial cancer, which is a cancer of the lining of the uterus.
If you still have a uterus, your doctor will prescribe progesterone in
addition to the estrogen to counteract this risk. There is still a slight
increase in endometrial cancer even with this dual therapy, but endometrial
cancer is easily detected by it's symptom of abnormal uterine bleeding.
If you experience abnormal bleeding after menopause, whether you are taking
hormones or not, consult your gynecologist immediately so that she can
take a small sample of the uterine lining for diagnosis. Another problem
that many women are concerned about is breast cancer. Certain breast cancers
are "estrogen sensitive" , meaning that if you are already predisposed
to having breast cancer the estrogen therapy will accelerate the process.
Therefore, the estrogen therapy does not cause the cancer but can worsen
a condition that is already present. Absolute contraindications to beginning
hormone replacement therapy are clotting disorders ( if you have had blood
clots in the past such as in the legs or lung ) or a personal history of
having an estrogen sensitive cancer.
Hormone replacement therapy can be given in several
different ways, most commonly by taking pills daily or by placing a "patch"
on the skin. The dose of hormone must be tailored to your body's needs
and may take a period of adjustment to get just right. It can also be prescribed
so that you continue to have menstrual periods or so that you don't. These
decisions are ones which you must discuss with your physician.
When trying to decide if hormone replacement is right for you, remember that any course of medical treatment requires the balance of risks and benefits. Any medication will have risks, and you must decide with your doctor whether the benefits outweigh the risks in your own case.