Nowadays, all women live over thirty per cent of their lives with menopause. Have we ignored what this means?
In 2003, the scientists announced that hormone replacement therapy considerably increased the risk of breast cancer and heart disease, which resulted in millions of women quitting their hormones. Whilst the real risks associated with hormone therapy in the research were not high, the influence this would have on women’s lives was mostly forgotten.
Hormone Fallout
Below you can read what we heard three years ago:
Four years ago, the Women’s Health Initiative (WHI) demonstrated that after five years of hormone replacement therapy (HRT), a risk of experiencing a heart attack by women increased by 24 per cent.
This is one of the ways of looking at the numbers. Below you can read another way.
For every ten thousand women taking such hormones as estrogen and a progestin, six more women would experience a heart attack within the period of twelve months. In other words, thirty six women taking estrogen and progestin at the same time would suffer from heart attacks in comparison with thirty women taking a placebo.
But these were only preliminary data.
After all the findings had been carefully analyzed, the scientists did not discover any overall increase in the risk of heart attack with HRT. Furthermore, hormones did not reduce the risk of having heart disease - in contrast to what was thought for many years.
These days we know that hormone replacement therapy should not be used to prevent heart disease. However, hormones constitute the most effectual treatment of symptoms of menopause including hot flashes and vaginal dryness, which remain the main reasons for using HRT.
Breast Cancer and HRT
And how about breast cancer?
A lot of women are worried about having breast cancer more than heart disease - the most important killer of women in the United States.
The WHI research revealed a 24- per cent increase in breast cancer risk after five years of using hormone replacement therapy. Yet again, when described that way it seems to be a very high risk.
An average woman that undergoes menopause – fifty years old - has about a 2.8 per cent risk of suffering from breast cancer before she exceeds the age of sixty.
In other words, out of every hundred women in the age of fifty, 2.8 of them will suffer from breast cancer before the age of sixty. With hormone replacement therapy, the risk of this disease rises to 3.5 women. Less than one additional woman is placed at risk resulting from HRT.
Another latest study deals with women from the WHI research who used to take hormones to help preserve mental function. These women were also required to quit hormone replacement therapy. The preliminary data proved that there was a double risk of dementia with the use of hormone replacement therapy.
This part of the research included more than 4,500 women. Fifty per cent of them were given hormone replacement therapy.
Generally, a double risk meant that forty women in the hormone replacement therapy group experienced probable dementia – in comparison with twenty one women who had not been given hormone replacement therapy.
The fallout from this research was that millions of women gave up using hormone replacement therapy because of their worries of having heart disease and breast cancer. This left many women undergoing several years of menopause with no treatment for their symptoms, such as hot flashes and vaginal dryness.
Unanswered Questions
It is still not clear what all of these findings have to do with the ordinary menopausal woman, especially the woman experiencing menopausal symptoms. When the WHI analyzed the risks and benefits of hormone replacement therapy, it did not observe women having suffering from symptoms - only at older women using hormone replacement therapy in oreder to prevent the diseases.
There is still one area that is not clear: whether or not younger women who start using HRT for symptoms would be at the same increased risk of developing breast cancer. However, when the scientists compiled findings of various studies, they discovered that the majority of the studies looking at the risk of breast cancer in women on hormone replacement therapy have not discovered greater risk.
For Women With Symptoms
The most frequent reason why women use hormone replacement therapy has always been to alleviate menopausal symptoms.
We are aware that HRT is the most effective way of treating the menopausal symptoms.
After quitting hormone replacement therapy, a lot of women experience bothersome symptoms such as hot flashes, tiredness, difficulty sleeping, excess sweating, depression, and vaginal dryness.
The results of the WHI did not prove that women should not use hormone replacement therapy for the symptoms of menopause.
Hormone replacement therapy may have a positive influence on other factors of menopause, including sleep quality, mood, sexual function, and skin changes.
When Hot Flashes Arise Again
According to the latest research published in The Journal of the American Medical Association, more than fifty per cent the women using HRT continued to suffer from hot flashes almost one year after quitting treatment.
The author of the research concludes: "these results should be considered when recommending women hormone replacement therapy for the treatment of menopausal symptoms for as short duration as possible."
Therefore, what can we do for these women nowadays - and for other women living with menopausal symptoms?
The research indicates that there is no short-term solution for the symptoms of menopause.
However, menopause does not last for just one or two years. Women must live with menopause for one third of their lives.
How will this influence their aging bodies and their quality of life? At this moment, nobody is able to predict.
Whilst more and more women decide about turning to alternative therapies to control menopausal symptoms, there is very little evidence concerning the security and effectiveness of many of these products.
Menopausal symptoms are most commonly treated by such ways as relaxation, herbal medications like black cohosh, and dietary soy. These may bring relief of ‘mild’ symptoms in general, however moderate and severe hot flashes may not be alleviated by these treatments.
Sexual complaints affect twenty five to nearly fifty per cent of women and worsen with age. Hormone replacement therapy is effective in preventing and treating these symptoms.
The FDA counsels hormone therapy for as short duration as possible. According to The North American Menopause Society, extended use of HRT is acceptable for women on one condition: if in their opinion there are more benefits than the risks.
We have to stop thinking in short terms. Unfortunately, menopause is not a short-term experience. Women who experience the symptoms of menopause have to realize that treatment is available, particularly in the form of hormone replacement therapy hormone replacement therapy. As physicians, we have to continue to address women’s worries and treat their symptoms with the most effective ways.
