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WHAT
ARE THE ADVANTAGES OF HORMONE REPLACEMENT THERAPY?
Today, women are being bombarded with many controversial studies
on the advantages of hormone replacement therapy (HRT). You may have been informed that estrogen
helps prevent heart attacks, protects against osteoporosis, and eliminates the
risk of cancer. Some studies suggest a
positive connection between HRT on one’s mood, mental function, and
preservation of an active sex life. In
addition, researchers have been looking at whether HRT offers any protection
against Alzheimer’s disease. So far,
studies have found favorable results on osteoporosis, menopausal symptoms, and
vaginal changes with the use of hormone replacement therapy.
OSTEOPOROSIS
Osteoporosis is a potentially crippling disease that causes bone
to loose their strength, often becoming so porous or brittle that they break
easily. Bone is a living tissue that is
constantly being renewed through a process in which old bone is removed, and
replaced by new bone. This is nature’s
way of restoring bones, and keeping them strong. Estrogen is the key to maintaining bone mass.
In menopausal women, there is a drop in estrogen levels which leads to an
imbalance between production of new bone, and re-absorption of old bone. Basically, bone is either removed too
quickly, or it is replaced too slowly. The
loss of bone mass causes bone to become thin, brittle, and weakened where it
becomes deformed, and prone to break (Curry & Hogstel, 2002).
Osteoporosis is a serious problem for postmenopausal women. During this time, bone loss occurs at a rate
of 1-5% per year and it is greatest in the first 5 years of menopause. Also, postmenopausal women have a lifetime
risk of hip fracture of 12-20%, a wrist fracture of 15%, and a vertebral
fracture risk of 32% (Lowdermilk, Perry, Bobak, 2000).
A way to replace the hormones lost during menopause is through
hormone replacement therapy (HRT). Over the years, researchers believe that HRT
is beneficial in preventing osteoporosis. Data from the Postmenopausal
Estrogen/Progestin Intervention study suggests that women who received HRT have
a net gain in bone mineral density when compared with women using placebo
(Basil, & Mutch, 2001).
Additionally, researchers have shown that estrogen reduces the risk of
vertebral fracture by 50%, and the risk of hip, wrist, and other non-vertebral
fractures by 25 to 30%. To achieve maximal benefit in preventing osteoporosis,
long term-hormone therapy (minimum of seven-years) is required (Manson &
Martin, 2001).
MENOPAUSAL
SYMPTOMS – HOT FLASHES
Hot
flashes are the most common symptom that occurs up to 70-80% of menopausal
women. The physiology of hot flashes (flushes) is not fully understood by the
medical community. It is certainly
related to the fluctuating levels of estrogen in circulation, which leads to a
sudden expansion and increased blood flow to the blood vessels in the
skin. So, when you are having hot
flashes, there is a sudden feeling of warmth that maybe accompanied with
sweating, blushing, increased pulse rate and blood pressure. These symptoms may lead to sleep
disturbances, fatigue, and irritability.
Typically, hot flashes are minimized within 1-2 years without treatment.
However, some women may continue to experience hot flashes for more than 20
years. Many studies suggest that HRT is
highly effective means of alleviating hot flashes. Recently, studies were
conducted to determine if there is a reduction in hot flashes in postmenopausal
women who are administered continuously with different dose combinations of
norethindrone acetate and ethyinyl estradial (NA/EE). The researchers concluded
that the combinations of NA/EE was effective, because within 4 to 8 weeks,
women reported either complete elimination of hot flashes, or had a least 74%
reduction (Speroff, 2000).
VAGINAL CHANGES
Menopausal
women may experience a variety of other symptoms, including vaginal dryness,
discomfort during sexual intercourse, and decreased libido. The reproductive
organs experience major changes at the time of menopause. Estrogen loss causes shrinkage of genital
tissues. For example, the vulva and the
vagina are less elastic, which makes it dryer, thinner, flatter, narrower, and
shorter. These changes increase the
women’s risk of tearing, painful intercourse, urinary incontinence, urinary
tract infections, painful or difficult urination, and genital prolapsed. The use of HRT can help maintain the
integrity of the tissues in the vaginal area (Lowdermilk, Perry, Bobak, 2000).
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Home What is menopause Types of Hormone Replacement Therapy Controversial
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Links Is HRT for You