Thursday, September 11th, 2008
John Russell asked:
It is generally agreed by many physicians that the primary reason for Hormone Replacement Therapy (HRT) is symptom relief from menopause, with less emphasis on using hormone therapy for disease prevention. It is important that the woman know all risks and benefits associated with HRT and reminded that the risk for breast cancer does increase naturally for all women as they age, as does the risk of heart disease and osteoporosis. “Women with a uterus who are currently taking estrogen plus progestin should have a serious talk with their doctors to see if they should continue it. If they are taking this hormone combination for short-term relief of symptoms, it may be reasonable to continue, since the benefits are likely to outweigh the risks. Longer term use or use for disease prevention must be re-evaluated, given the multiple adverse effects noted in Women’s Health Initiative (WHI).”
One physician associated with the WHI says, “always cautions patients about the potential for increased breast cancer risks.” First, she rules out women who are not candidates for HRT - those with bleeding problems of an unknown cause, suspected breast cancer or history of breast cancer, history of endometrial cancer or certain cancers of the uterus, chronic liver disease such as cirrhosis or a history of blood clots.
She further tells her patients who want to stop HRT that they can certainly quit anytime. First of all, with menopause, we’re not treating a disease, and stopping HRT has no major consequences, except perhaps a return of the original menopausal symptoms.
For both women who want to stop taking HRT and for women who choose not to start HRT, there are alternative therapies. For almost everyone, there are other treatment options. For instance, women they can reduce their risk of heart disease by stopping smoking and by keeping their weight, cholesterol levels and blood pressure under control. Prozac and some other antidepressants can relieve hot flashes. Prescription drugs such as Fosamax help protect against osteoporosis. Also, the drug Evista (raloxiphene HCI), prevents osteoporosis and further claims to lower total cholesterol and prevent breast cancer. However, because women on Evista may experience more hot flashes, it raises questions about how that might affect the brain. Research now suggests a link between hot flashes and Alzheimer’s. Evista belongs to a class of drugs called SERMs, or Selective Estrogen Receptor Modulators. A SERM being used in Europe Tibolone, may be more effective without the side effects found in Evista.
Noah
It is generally agreed by many physicians that the primary reason for Hormone Replacement Therapy (HRT) is symptom relief from menopause, with less emphasis on using hormone therapy for disease prevention. It is important that the woman know all risks and benefits associated with HRT and reminded that the risk for breast cancer does increase naturally for all women as they age, as does the risk of heart disease and osteoporosis. “Women with a uterus who are currently taking estrogen plus progestin should have a serious talk with their doctors to see if they should continue it. If they are taking this hormone combination for short-term relief of symptoms, it may be reasonable to continue, since the benefits are likely to outweigh the risks. Longer term use or use for disease prevention must be re-evaluated, given the multiple adverse effects noted in Women’s Health Initiative (WHI).”
One physician associated with the WHI says, “always cautions patients about the potential for increased breast cancer risks.” First, she rules out women who are not candidates for HRT - those with bleeding problems of an unknown cause, suspected breast cancer or history of breast cancer, history of endometrial cancer or certain cancers of the uterus, chronic liver disease such as cirrhosis or a history of blood clots.
She further tells her patients who want to stop HRT that they can certainly quit anytime. First of all, with menopause, we’re not treating a disease, and stopping HRT has no major consequences, except perhaps a return of the original menopausal symptoms.
For both women who want to stop taking HRT and for women who choose not to start HRT, there are alternative therapies. For almost everyone, there are other treatment options. For instance, women they can reduce their risk of heart disease by stopping smoking and by keeping their weight, cholesterol levels and blood pressure under control. Prozac and some other antidepressants can relieve hot flashes. Prescription drugs such as Fosamax help protect against osteoporosis. Also, the drug Evista (raloxiphene HCI), prevents osteoporosis and further claims to lower total cholesterol and prevent breast cancer. However, because women on Evista may experience more hot flashes, it raises questions about how that might affect the brain. Research now suggests a link between hot flashes and Alzheimer’s. Evista belongs to a class of drugs called SERMs, or Selective Estrogen Receptor Modulators. A SERM being used in Europe Tibolone, may be more effective without the side effects found in Evista.
Noah