Who Shouldnt Use Hrt:
The benefits of hormone therapy are well understood, but your; doctor may decide HRT is not right for you if you have had;
- Breast cancer
- Liver disease
You also shouldnt use HRT if theres any chance you might be pregnant.
*If women experience unwanted side effects when taking HRT for the first time, these symptoms can usually be resolved by changing the type, dose or route of HRT . It is important that women are aware that, for the vast majority under the age of 60 years, the benefits of hormone replacement therapy outweigh any risks.
Estrogen Therapy And Cancer Risk
In women who still have a uterus, using systemic ET has been shown to increase the risk of;endometrial cancer;. The risk remains higher than average even after ET is no longer used. Although most studies that showed an increased risk were of women taking estrogen as a pill, women using a patch or high-dose vaginal ring can also expect to have an increased risk of endometrial cancer.
Because of this increased cancer risk, women who have gone through menopause and who still have a uterus are given a progestin along with estrogen. Studies have shown that EPT does not increase the risk for endometrial cancer.
Long-term use of vaginal creams, rings, or tablets containing topical estrogen doses may also increase the levels of estrogen in the body. Its not clear if this leads to health risks, but the amounts of hormone are much smaller than systemic therapies.
ET is not linked to a higher risk of;breast cancer. In fact, certain groups of women taking ET, such as women who had no family history of breast cancer and those who had no history of benign breast disease, had a slightly lower risk of breast cancer.
The WHI study of ET did not report any results about;ovarian cancer.
To put the risk into numbers, if 1,000 women who were 50 years old took estrogen for menopause for 5 years, one extra ovarian cancer would be expected to develop.
ET does not seem to have any effect on the risk of;lung cancer.
Ideal Timing Of Bioidentical Hormone Replacement Therapy
Since menopause can be so unique to each individual, the answer to this question will vary for everybody. In a perfect world, every person would recognize the exact moment they entered menopausal transition. Yet, it often doesnt work like this. It can take people a long time to recognize some of the feelings they have experienced as being symptoms of menopause. Oftentimes, people will write off symptoms as normal signs of aging.
If there is an ideal time for a person to begin bioidentical hormone replacement therapy, its whenever that person notices they are suffering from menopausal symptoms that hinder their ability to enjoy a high quality of life. This isnt to say that the negative effects of menopause can be mitigated by BHRT alone; you can make lifestyle changes, such as improved diet and exercise, which can have a positive effect in reducing the symptoms of menopause. Yet, theres a good chance that such positive lifestyle changes will start to lose effectiveness as you get further into menopausal transition. At that point, combining the use of bioidentical hormones with a healthy lifestyle could be just the thing you need to correct the imbalance of your hormone levels that come with the onset of menopause and andropause.
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Do Local Formulations Of Menopausal Hormone Therapy Have Different Risks
Both systemic and local treatment options for MHT are available in the United States. Which option a woman receives depends on the menopausal symptoms the treatment is meant to address. Systemic MHT is usually prescribed to treat hot flashes and to prevent osteoporosis. Systemic MHT with combined estrogen plus progestin or with estrogen alone can be given as oral medications; as transdermal patches, gels, or sprays; and as implants.
Local MHT is prescribed to treat genitourinary symptoms such as vaginal dryness. Local MHT contains low-dose estrogen only and is prescribed to women regardless of their hysterectomy status. Local MHT with low-dose estrogen alone includes creams, tablets , and rings.
Findings from the Womens Health Initiative Observational Study showed that, among women with an intact uterus, those who used vaginal estrogen and those who didnt had similar risks of stroke, invasive breast cancer, colorectal cancer, endometrial cancer, and pulmonaryembolism/deep vein thrombosis .
Hrt Does Not Cause Weight Gain
Weight gain at the menopause is related to age and lifestyle factors. An increase in body fat, especially around the abdomen, can occur during menopause because of hormonal changes, although exactly why this happens is not clear. Normal age-related decrease in muscle tissue, and a decrease in exercise levels, can also contribute to weight gain.
Most studies do not show a link between weight gain and HRT use. If a woman is prone to weight gain during her middle years, she will put on weight whether or not she uses HRT.;
Some women may experience symptoms at the start of treatment, including bloating, fluid retention and breast fullness, which may be misinterpreted as weight gain. These symptoms usually disappear once the therapy doses are changed to suit the individual.
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Should You Try Hormone Replacement Therapy
HRT is usually prescribed for a woman who is experiencing menopausal symptoms that affect her health and quality of life. You can weigh your options with help from your OB/GYN. However, due to the possible complications or heightened risks from using HRT, alternatives may be suggested if any of the following applies to you18:
- You are pregnant.
- You have high blood pressure problems that arent being treated.
- You have had ovarian, breast, or womb cancer.
- You have liver disease.
- You are prone to blood clots.
|Polo-Kantola, Päivi, Risto Erkkola, Hans Helenius, Kerttu Irjala, and Olli Polo. When does estrogen replacement therapy improve sleep quality?. American journal of obstetrics and gynecology 178, no. 5 : 1002-1009.|
Here Are Some Questions You Can Ask Yourself And Discuss With Your Physician:
- Am I experiencing difficult menopause symptoms?
- Do I have any medical conditions or a family history of certain conditions that might make HRT beneficial for me?
- Do I have any medical conditions or a family history of certain conditions that might make HRT riskier for me?
- Have I considered alternatives to HRT?
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Is Hormone Replacement Therapy Safe
The use of pellet implants as a treatment option for hormone replacement therapy has been around for a while. Since 1939, pellet implants have been documented as an effective and popular method of hormone administration. It wasnt until the 1970s that other methods were introduced, such as oral and topical products.;
Hormone pellets have remained outside the realm of commercial pharmaceuticals because they are naturally based. Also because they match our own genetical structure and ultimately, cannot be patented. Opposite of a synthetic drug, studies continue to show the effectiveness of natural hormone replacement therapy. In addition, the positive impact it has on the lives of the men and women who use it. Natural hormone therapy continues to become more regularly used among practitioners. It has also seen steady growth in providers who specialize in hormone replacement therapy.;
Cardiovascular Disease And Hrt
Women over 60 have a small increased risk of developing; heart disease or stroke on combined oral HRT. Although the increase in risk is small, it needs to be considered when starting HRT, as the risk occurs early in treatment and persists with time.
Oestrogen used on its own increases the risk of stroke further if taken in tablet form, but not if using a skin patch. Similarly, tibolone increases the risk of stroke in women from their mid-60s.
Women who commence HRT around the typical time of menopause have lower risks of cardiovascular disease than women aged 60 or more.
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Whats Been Approved By The Us Food And Drug Administration
The U.S. Food and Drug Administration approves all estrogen therapy medications. Some hormones are sold as bio-identical hormones and are not FDA-approved. They are available without a prescription, and they are not held to the same safety standards as prescription medications. Despite marketing claims, these hormones are also not more natural than the FDA-approved treatments.
Is Hrt The Same As Birth Control
No. Although women who take birth control pills are also taking estrogen and progestin, the effect is not the same. Women who take birth control pills have not been through menopause and need higher levels of hormones to prevent ovulation. HRT is not a high enough strength to stop ovulation.
After menopause, estrogen levels are low and HRT is used at a low dose to restore hormone levels to a more normal level.
What Are The Risks
Hormone therapy is not right for everyone. Women who start treatment over age 60 or more than 10 years from the start of menopause have increased risks for certain health conditions. Women who have higher risks for blood clots, breast cancer, or liver disease may also not be good candidates for hormone therapy. Before starting any treatment, speak with a healthcare provider about risks and benefits.
Misconceptions Surrounding Hormone Replacement Therapy
Many women who come into New Beginnings OB-GYN are wary of HRT because they want to go through menopause naturally, or theyre afraid that HRT may be dangerous.
The bad press hormone replacement therapy has received is largely derived from just two studies that took place in the 1990s, which showed there may be an increased risk of breast cancer and cardiovascular disease amongst women receiving HRT. More recent studies, however, have shown that there appears to be a far smaller risk than the initial findings may have suggested.
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Understanding The Facts Of Hormone Pellet Therapy
Its important to note, though, hormone replacement therapy isnt right for every woman and may not provide these benefits for everyone. Working with your doctor to determine if this treatment is a good idea is essential.
Understanding the benefits and risks of this treatment can help you figure out if this treatment is right for you. If you are interested in learning more about hormone replacement therapy or figure out if you are a candidate, contact us. Our team can help you manage your health conditions and provide effective and safe treatments.
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Post Menopausal Hormon Replacement Therapy
How prevalent is heart disease among women?
Female Reproductive Organs
Cardiovascular disease is NOT just a mans disease. Cardiovascular disease is the Number 1 killer of women over age 25 in the United States, regardless of race or ethnicity. Once a woman reaches the age of 50 , the risk for heart disease increases. In young women who have undergone early or surgical menopause, the risk for heart disease is also higher, especially when combined with other risk factors such as:
- Elevated LDL cholesterol
- Low HDL cholesterol, sometimes called “good” cholesterol
- Family history of heart disease
What is menopause?
Menopause is a normal stage in a womans life. The term menopause is commonly used to describe any of the changes a woman experiences either before or after she stops menstruating. As menopause nears, the ovaries gradually produce less estrogen , causing changes in the menstrual cycle and other physical changes. The most common symptoms of menopause are hot flashes, night sweats, emotional changes and changes in the vagina .
Technically, menopause is the end of a womans reproductive cycle, when the ovaries no longer produce eggs and she has her last menstrual cycle. The diagnosis of menopause is not confirmed until a woman has not had her period for six to twelve consecutive months.
How is heart disease associated with menopause?
What can be done to reduce the risk of heart disease for menopausal women?
Insomnia Lack Of Sleep
Heres one thing we can all agree on: a good nights sleep is vital to living a healthy life. When our sleep cycle is tampered with, a simple day at work can seem like an impossible task. If you are experiencing disturbances in your sleep cycle, hormone imbalances may be the main force keeping you up at night.;
Other side effects you may feel when hormones interrupt sleep include:;
- Hot flashes and night sweats
- Brain fog and memory loss
As you can see, all of these are very negative symptoms of a lack of sleep and can be easily improved with hormone replacement therapy. So, how can you safely and effectively replenish your hormones through hormone replacement therapy?
How Do The Hormones Used In Mht Differ From The Hormones Produced By A Womans Body
The hormones used in MHT come from a variety of plants and animals, or they can be made in a laboratory. The chemical structure of these hormones is similar, although usually not identical, to those of hormones produced by womens bodies.;;;;;;;;;;
Non-FDA-approved hormone products, sometimes referred to as bio-identical hormones, are widely promoted and sold without a prescription on the Internet. Claims that these products are safer or more natural than FDA-approved hormonal products are not supported by credible scientific evidence. The FDA provides more information about these products on its Menopause page.
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How To Get Started On Hrt
Speak to a GP if you’re interested in starting HRT.
You can usually begin HRT as soon as;you start experiencing menopausal symptoms and will not usually need to have any tests first.
A GP can explain the;different types of HRT;available and help you choose one that’s suitable for you.
You’ll usually start with a low dose, which may be increased at a later stage. It may take a few weeks to feel the effects of treatment and there may be some;side effects at first.
A GP will usually recommend trying treatment for 3 months to see if it helps. If it does not, they may suggest changing your dose, or changing the type of HRT you’re taking.
Benefits Youll Get With Hormone Therapy
The most effective treatment for these symptoms remains to be systemic estrogen therapy.;
Women have a high risk of developing a bone-thinning disease called osteoporosis during the perimenopausal or menopausal stage. Estrogen therapy can help decrease this risk.;
These benefits can help improve your sleep, sexual relationship, and quality of life.;
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Keep Your Cool: Reduce Night Sweats And Hot Flashes
The biggest reason to choose HRT is to alleviate some of the problems associated with menopause, including night sweats and hot flashes.2 Hot flashes are believed to be the result of hormonal changes that affect your bodys ability to manage temperature. This can cause a sudden rush of heat through your body that can make you sweat, turn red, and even experience heart palpitations. This can happen from a few times a day up to 20! Some women are even plagued by hot flashes all the way into their 70s and 80s.3 This problem may also cause you to wake up drenched in sweat . Since HRT restores the hormonal balance, it helps your body regulate temperature, which means you can avoid this discomfort.
Benefits Of Hormone Replacement Therapy You Need To Know
Whether youre a man or woman, imbalanced hormone levels can impact your life in a negative way.; Imbalanced hormones can throw your body completely out of balance and cause you to have mood swings, weight gain, memory loss and even acne.;
If youre looking to sleep better, reduce hot flashes, improve your sex life, hormone replacement therapy might be the key to solving your hormone imbalance.;
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Prescribing Hormone Replacement Therapy
It is important that an individualised approach is undertaken at all stages of diagnosis, investigation and management of menopause.
The dose, regimen and duration of HRT need to be individualised. There is no maximum duration of time for women to take HRT. Discussion with women who continue to have symptoms generally show their benefits from HRT usually outweigh any risks. Systemic HRT should not be arbitrarily stopped at age 65 years; instead treatment duration should be individualised based on patients’ risk profiles and personal preference.
Micronised progesterone is a natural, ‘body-identical’ progestogen, devoid of any androgenic as well as glucocorticoid activities but being slightly hypotensive due to anti-mineralocorticoid activity. It may be the optimal progestogen in terms of cardiovascular effects, blood pressure, VTE, probably stroke and even breast cancer but this evidence is only from observational studies. There is only one currently available to prescribe in the UK.
As transdermal oestrogen is associated with fewer risks than oral HRT, a transdermal route may be preferable for many women. This route is also advantageous for women with diabetes, history of VTE and also those with thyroid disorders. In addition, transdermal HRT is preferable to those women with a history of migraine or gallbladder problems.