Deciding whether or not hormone replacement therapy (HRT) is right for you is no easy task. HRT is surrounded by a lot of information and misinformation that leave us feeling more confused. Is HRT really beneficial for women in menopause? Does HRT do us more harm than good? Unfortunately there are no cut and dried answers to these and other questions about HRT. But the first step in making such an important decision is sorting out the myriad of information out there to understand the pros and cons of taking HRT.

Are there benefits to HRT?
Some women will find that HRT does lessen the severity of their menopausal symptoms; others will find little or no help. Some women may find that their increased risks for certain diseases stem from taking HRT. Like menopause itself, every woman will have her own experience with HRT. This means that we can learn about the good and the bad from friends and family but that what others are going through may not apply to our situations.

HRT replaces the diminishing levels of estrogen in our bodies. HRT is touted for its ability to decrease the risk of osteoporosis and those dreaded hip fractures. Some studies suggest HRT lowers a woman’s risk of developing colon cancer or heart disease, but these findings are still in the early stages. The more immediate improvements women notice while taking HRT are fewer night sweats or hot flashes, mood swings, and irritability. HRT also alleviates vulvar discomfort including dryness and painful intercourse.

What about the risks?
Just as confusing are the increased risks associated with taking HRT that appear to contradict the above. The Women’s Health Initiative (WHI) has researched several women taking the estrogen-progesterone combination, marketed under the name Prempro, and found that over a one year period 10,000 women were at higher risks for blood clots, stroke, breast cancer, and heart disease.

For women taking estrogen alone (Premarin) the WHI noticed that the 10,000 women studied did not appear to have increased risks for breast cancer or heart disease. Yet they still showed increased risks for blood clots and stroke. Some women also discovered that they received abnormal mammography readings as taking estrogen can affect the composition of breast tissues.

Who is more likely to benefit from HRT?
If your menopausal symptoms are mild to moderate (they are not significantly impacting your daily life) HRT taken on a short term basis can make living with menopause much easier.

Who should avoid HRT?
Women with heart disease, breast cancer, or a tendency to develop blood clots are not the best candidates for HRT.

The problem emerging is that for some women HRT benefits will outweigh the risks while others will experience the exact opposite. The problem with the numerous studies out there is that many of the findings have not been over a long period of time; most studies have been conducted within the last 10 years or so.

The worst part in all of this is that in deciding about HRT, we are left with the answer ‘no one is really sure’ which is no answer at all.


Menopause, Your Doctor, and You