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Q: I am a 50 year old woman and am suffering from postmenopausal hot flashes. My doctor is recommending hormone replacement therapy, but I am scared of its risks. What should I do?
Until a few years ago, hormone replacement therapy (estrogen +/- progestin) used to be a standard treatment for postmenopausal women with hot flashes and other menopausal symptoms. Hormone replacement therapy (HRT) was also believed to have a number of other health benefits.
All this changed when a large trial found that the treatment actually posed more health risks than benefits (for one particular type of hormone therapy), especially when given to older postmenopausal women.
Still, HRT remains a good choice for certain women, depending on their risk factors.
How does HRT help?
NOTE: For women who experience menopause naturally (still have the uterus), estrogen is typically prescribed along with progesterone or progestin. This is because estrogen alone, when not balanced by progesterone, can increase the risk of uterine cancer. Women who have had their uterus removed (hysterectomy) don’t need to take progestin.
What are the risks of HRT?
In a large clinical trial, a combination estrogen-progestin pill (Prempro) increased the risk of certain serious conditions, including:
However, the risks of hormone therapy may vary depending on whether estrogen is given alone or with a progestin, and depending on your current age and age at menopause, the dose and type of estrogen, and other health risks such as your risks of heart and blood vessel (cardiovascular) disease, cancer risks and family medical history.
Who are good candidates for HRT?
The following two groups of women are perfect candidates:
Who should NOT take HRT?
All of the above information should be considered and discussed with your doctor in deciding whether hormone therapy might be an option for you.
This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra’s “The Doctor is In” column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.firstname.lastname@example.org