The Health Risks And Benefits Of Hrt
In 1991, the U.S. National Institutes of Health launched the Women’s Health Initiative , a set of studies involving healthy post-menopausal women that was carried out in 40 U.S. centres. The WHI included a clinical trial to evaluate the risks and benefits of the two types of HRT and to see how they affected the incidence of heart disease, breast cancer, colorectal cancer and fractures in post-menopausal women. The trial was divided into two arms:
- One arm involved more than 16,000 post-menopausal women aged 50 to 79 who had not had a hysterectomy. They took pills daily that were either a combination of estrogen and progestin , or a placebo .
- The second arm involved more than 10,000 women who had received a hysterectomy and who took estrogen pills alone or a placebo.
In July 2002, after an average 5.2 years of regular follow-up, the NIH prematurely ended the combined HRT arm of the WHI trial. An independent monitoring board, which regularly reviewed the findings, concluded that there were more risks than benefits among the group using combined HRT, compared with the placebo group. The study found that changes in the incidence of disease per 10,000 women on combined HRT in one year were:
- Seven more cases of coronary heart disease
- Eight more cases of strokes
- Eighteen more cases and a twofold greater rate of total blood clots in the lungs and legs
- Eight more cases of invasive breast cancer
- Six fewer cases of colorectal cancer
- Five fewer cases of hip fractures
What Are Some Of The Benefits Of Bioidentical Hormone Replacement Therapy
There are many benefits gained by the natural, customized approach of BHRT, including:
- Improved weight loss
- Improved look and feel of hair and skin and nails
- Improved mental health
- Improved mood and emotional balance
- Relief of hot flushes and night sweats
- Restful and restorative sleep
- Feeling yourself again
As a Bio-identical Hormone Specialist, Dr. Arnold can provide you with detailed safety information, answer all your questions, and discuss any concerns you may have. He will listen carefully to your description of your symptoms, and will give you information about the hormone testing that is best suited to your symptoms.
Please note that Bio-Identical hormone replacement therapy is viewed by OHIP as complimentary or alternative medicine and as such is NOT COVERED by OHIP. All services at the clinic are billed directly to you and payment is due at the time the service is provided. Although your insurance may cover you for these services, you are responsible for paying for all services and submitting your receipts to your insurance company for re-imbursement.
Signature Hormones by Dr. Arnold is not able to tell you whether your insurance plan will cover any of the services provided. All medical services provided can be deducted on your taxes. Signature Hormones by Dr. Arnold accepts payment by cash, INTERAC, VISA and MASTERCARD.
Do I Need A Prescription For Hormone Replacement Therapy
Yes. In the U.S., HRT is not available without a prescription. Because of the potential risks involved, you should talk with a healthcare provider before starting HRT.
Though its possible to get HRT over the internet or through the mail, you should be wary of any online pharmacies willing to sell hormones without a prescription. If you do get your medications online, make sure you use only a provider verified by the National Association of Boards of Pharmacy, like GoodRx.
If you are interested in getting a prescription for HRT, you can talk to your healthcare provider about options. Some people may prefer to work with an OB-GYN or menopause specialist.
You can also consider a telehealth consultation like GoodRx Care an especially convenient option during COVID-19. There are even menopause-specific telehealth options for managing all of your care from home. If finances are a challenge, many free clinics and Planned Parenthood are offering virtual options during COVID-19.
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Hrt And Cancer There Is Strong Evidence That Using Hrt Raises A Womans Risk Of Breast Ovarian And Uterine Cancers At The Same Time It May Lower The Risk Of Colorectal Cancer
Combined HRT for menopause is a known cause of breast cancer, mainly in women who recently used or are still using the therapy. There is also some evidence suggesting that estrogen-only HRT may also increase the risk of breast cancer.
Studies suggest that both combined and estrogen-only HRT increase a womans risk of ovarian cancer but the risk is low.
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Where To Get Online Hormone Replacement Therapy & Testosterone Replacement Therapy
Paying attention to your sexual and reproductive health is more important than you think. Since everyone has a right to access sexual and reproductive healthcare and decide what to do with their bodies, some people consider Hormone Replacement Therapy and Testosterone Replacement Therapy to improve their hormone balance, increase their libido, and attain beneficial effects.
Hormone Replacement Therapy and Testosterone Replacement Therapy have beneficial effects.Pexels
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What Are The Types Of Hormone Therapy
HT is a medical treatment that uses hormones to treat certain conditions. Types of hormone therapy include:
Menopausal hormone therapy, which uses estrogen and progesterone to lessen the severity and frequency of menopausal symptoms
Breast cancer prevention hormone therapy, which prevents breast cancer from developing by lowering the amount of estrogen in the body
Prostate cancer prevention hormone therapy, which lowers the amount of testosterone in the body to prevent prostate cancer
The three types of hormone therapy include oral hormone therapy, transdermal hormonal therapy, and injectable hormonal therapy.
Oral hormone therapy consists of tablets, pills, or patches that contain estrogen and progesterone. These medications can come in different forms and may be taken alone or with a birth control pill, and these medications can be taken for short or long periods.
Transdermal hormonal therapy involves applying a patch that contains both estrogen and progesterone to the bodys skin. This is more commonly used than other forms of hormonal therapy.
Injectable hormonal therapy consists of an injectable form of testosterone and estrogen. After the first trimester of pregnancy, most doctors do not recommend hormone therapy as it can decrease a womans chance of getting pregnant. It also puts her fetus at risk of health complications due to the high estrogen levels.
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Where Does Evidence About The Health Effects Of Mht Come From
The most comprehensive evidence about the health effects of MHT comes from two randomized clinical trials that were sponsored by the National Institutes of Health as part of the Womens Health Initiative :
- The WHIEstrogen-plus-Progestin Study, in which women with a uterus were randomly assigned to receive either a hormone pill containing both estrogen and progestin or a placebo. The median duration of treatment was 5.6 years.
- The WHI Estrogen-Alone Study, in which women without a uterus were randomly assigned to receive either a hormone pill containing estrogen alone or a placebo. The median duration of treatment was 7.2 years.
More than 27,000 healthy women who were 50 to 79 years of age at the time of enrollment took part in the WHI hormone therapy trials. The goals of these trials were to see if MHT prevents heart disease and bone fractures in postmenopausal women and to determine if MHT affects risks of breast cancer and, for women with a uterus, endometrial cancer. Both trials were stopped early , when it was determined that both types of therapy were associated with specific health risks, but long-term follow up of the participants continues to provide new information about the health effects of MHT.
When To Stop Taking Hrt
Most women are able to stop taking HRT after their menopausal symptoms finish, which is usually two to five years after they start .
Gradually decreasing your HRT dose is usually recommended, rather than stopping suddenly. You may find that your menopausal symptoms come back after you stop HRT, but these should pass within a few months.
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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.
Herbs And Supplements During Menopause
Many over-the-counter natural products are promoted in stores and online as helpful with menopausal symptoms. These include vitamins and soy-based and herbal products . There are also endless arrays of special blends of herbs and vitamins that claim to reduce the discomforts of menopause.
These products are considered dietary supplements . They have not been evaluated by the Food and Drug Administration to be sure that they work or even that they are safe. Some supplements have been tested in small clinical trials, but often the studies only looked at taking the substance for a short time , so it isnt clear how safe it would be if taken for a long time. Another concern has been applying the results of a study of a particular version and dose of a supplement to others that werent tested.
Most of the plain herbs that are touted for menopausal symptoms carry a low risk of harm for most women, but some can interact with other drugs and/or cause unexpected problems. You should discuss herbs or supplements with your doctor before taking them.
Well-controlled scientific studies are needed to help find out if these products work and if they are any safer than the hormone therapy drugs now in use.
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Principles Of Prescribing Hormone Replacement Therapy
HRT is contraindicated in women with unexplained vaginal bleeding, estrogen-sensitive breast and endometrial cancers, a history of blood clots, coronary artery disease, and elevated triglyceride levels, or chronic liver disease. HRT should be an individual decision that each woman makes with help from her clinician based on her quality of life and attitude toward menopause, time since menopause and menopausal symptoms, medical history, and risk factors.
Use the lowest effective dose of HRT to treat symptoms and minimize risks.
Initiate HRT early and treat for the shortest duration of time, regularly evaluating for ongoing need and effectiveness.
According to the Global Consensus Statement on Menopausal Hormone Therapy, Benefits are more likely to outweigh risks for symptomatic women before the age of 60 years or within 10 years after menopause. For combined estrogen and progesterone therapy, re-evaluate continued use at 3-5 years due to small increased risk of breast cancer. For estrogen-only therapy, duration of use can be longer.
Use the safest preparation of hormones that is associated with the lowest risks.
Consider vaginal administration of HRT if symptoms are limited to vaginal dryness. Consider transdermal or topical estrogen, which bypasses the first-pass liver effect resulting in a lower risk of venous thromboembolism compared to oral preparations.. Consider oral micronized progesterone rather than synthetic progestins to minimize breast cancer risk. .
What Is Testosterone Replacement Therapy
Testosterone is a male sex hormone known as androgen that plays a vital role in the reproduction, growth, and maintenance of a healthy body. It is normal for testosterone levels to decline as men get older but in some cases, it might be due to hypogonadism, a condition in which the body produces insufficient amounts of the hormone essential for male growth. The symptoms of low testosterone include:
- Erectile dysfunction
- Body and facial hair loss
- Low self-esteem and energy
- Mood swings and irritability
HRT Doctors Group provides convenient access to hormone-related healthcare.Pexels
When you undergo Testosterone Replacement Therapy, your testosterone will be supplied or replaced to increase its level. This kind of therapy can also help reverse the effects of hypogonadism on your hormones. This can be done in different ways, such as through a skin patch, a mouth patch, gel, and implants or injections.
Many patients seeking to address their respective symptoms often search for a TRT clinic near me and find that there are not always local board-certified doctors with extensive hormone therapy experience. For your convenience, HRT Doctors allows you to undergo Testosterone Replacement Therapy completely online. You can consult with doctors using any device from the comfort of your home, understand your condition clearly, and get the best treatment for you without risking your health.
Get the best treatment without risking your health.Pexels
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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.
Are There Alternatives For Women Who Choose Not To Take Menopausal Hormone Therapy
Women who are concerned about the changes that occur naturally with the decline in hormone production that occurs during menopause can make changes in their lifestyle and diet to reduce the risk of certain health effects. For example, eating foods that are rich in calcium and vitamin D or taking dietary supplements containing these nutrients may help to prevent osteoporosis. FDA-approved drugs such as alendronate , raloxifene , and risedronate have been shown in randomized trials to prevent bone loss.
Medications approved by the FDA for treating depression and seizures may help to relieve menopausal symptoms such as hot flashes . Drugs that have been shown in randomized clinical trials to be effective in treating hot flashes include venlafaxine , desvenlafaxine , paroxetine , fluoxetine , citalopram , gabapentin , and pregabalin .
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Shortage Of Some Hrt Products
There are ongoing supply problems with some HRT products. For some products this is because of irregular supply while for others it’s a longer-term shortage. There are lots of different reasons why medicines can be in short supply. Work is happening with the pharmaceutical manufacturers who make the medicines to help the situation.
If your pharmacy cant supply the specific HRT product you’ve been prescribed, they may supply an alternative product. This will usually have the same ingredient, but may be made by a different manufacturer. Your pharmacy might also reduce the amount they provide you with to help ensure that as many women as possible can get access to their required medication.
Disruptions in the availability of HRT will be worrying if it has been prescribed for you. However, there are always alternative options. If you are concerned about this, contact your GP, pharmacist or specialist doctor to discuss the best treatment options for you.
Putting The Risks Of Hrt In Perspective
Media reports on the WHI results may have given people inflated fears of hormone replacement therapy’s risks, the doctors say.
For example, the Women’s Health Initiative results showed that combined hormone replacement therapy seems to increase the risk of breast cancer by 33%, Schiff says. That’s a serious increase. Still, the risk to any one woman is not as high as it sounds, Schiff says.
“According to the WHI, without hormone therapy, 3 of every 1,200 women aged 55 to 59 will develop breast cancer this year,” says Schiff. “With hormone therapy, 4 out of 1,200 will. It’s a 33% increase, but the absolute risk is still very, very small.”
Shuster points out that other behaviors — like drinking two glasses of wine a night — also increase breast cancer risk by a similar amount.
Women who take estrogen alone — a treatment only available to people who have had a hysterectomy — appear to have a lower risk of developing breast cancer than women who take progestin and estrogen together. In a 2006 JAMA article, researchers from the Women’s Health Initiative found that after about seven years of treatment with estrogen, there seemed to be no increased risk of breast cancer.
However, estrogen-only therapy may have long-term risks. A May 2006 study published in the Archives of Internal Medicine found using estrogen-only therapy for 20 years or more showed increased risk of developing breast cancer.
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