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[1, 2]
Hormone Replacement Therapy
Chapter 2
Hormone replacement therapy has many noteworthy benefits, ranging
from major to minor. One of the biggest benefits of HRT is that
it greatly reduces the amount of calcium lost in bones, thus preventing
reduction in bone density as a result of osteoporosis. Although
long term HRT is often prescribed for prevention of osteoporosis,
it can't reverse bone density that has already been lost, but can
prevent further losses. An even greater benefit is that women taking
HRT experience a much lower rate of coronary heart disease and strokes.
Studies show that these women exhibit a huge reduction in occurrence
of these ailments, as great as up to 50%. This probably results
from HRT lowering the level of "bad" LDL cholesterol and
raising the level of "good" HDL cholesterol. In addition,
estrogen and memory are somehow connected and many post menopausal
women experience memory loss. Women taking HRT however, are 40-60%
less likely to develop Alzheimer's Disease. Additionally, women
already diagnosed with this disease show significant improvement
in memory function as a result of HRT. All of the other menopausal
symptoms as outlined previously, such as the hot flashes and vaginal
dryness are generally greatly reduced, if not totally eradicated
by employing HRT, even in quite low doses.
Although the benefits of taking HRT are significant, the risks
can be too. It is believed that HRT increases the incidence of breast
cancer. The matter remains quite controversial as many of the studies
have been inconclusive. As previously mentioned, another risk for
patients with intact uteruses taking estrogen only supplements have
a significantly higher risk of developing endometrial or uterine
cancer. In women who are taking both estrogen and progesterone,
this occurrence is greatly reduced, and in fact occurs less
than in women not taking HRT. Other side effects of HRT may include
withdrawal bleeding for the first three to six months, headaches,
nausea, breast tenderness and water retention, but the occurrence
and severity of these side effects varies greatly from individual
to individual. While it has been otherwise reported, there is no
evidence that HRT makes symptoms of depression worsen or causes
clotting abnormalities.
Although there are different varieties of HRT; most women require
the combination of both estrogen and progesterone for reasons previously
stated. It was formerly quite common for women to be told to take
estrogen during the beginning phase of their cycle and progesterone
for the latter part, but this seemed to increase the amount of monthly
bleeding and many women stopped taking the therapy. Now, it is most
common for the patient to take the estrogen and progesterone simultaneously
throughout the month, which seems to reduce the amount of bleeding
significantly and generally ends it altogether within six months.
HRT is most commonly taken orally in pill form, or alternately,
estrogen may be applied to an area of skin on the body via an adhesive
strip - rather like a band-aid. If the estrogen is taken through
the skin, it may not have all of the benefits as experienced in
the pill form. It is important to find out which is best for you
from your physician.
Many women find that the benefits of taking hormone replacement
therapy far outweigh the risks as it has significantly impacted
on the overall quality of their lives if in fact not the actual
span. However, some women are not good candidates for HRT, particularly
if they have or have had breast cancer, coronary heart disease,
blood clots, seizures, liver disease, gallbladder disease or migraine
headaches. It is important for your doctor to discuss with you your
personal probability of developing these conditions as compared
to preventing other conditions such as osteoporosis and weighing
the advantages and disadvantages to determine whether HRT is right
for you.
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