HRT: Weighing the Pros and Cons

Trying to keep up with the latest on hormone replacement therapy (HRT) can be tough.

"Women don't know what to believe anymore," says Shelley R. Salpeter, MD, director of medicine consultation services at Santa Clara Valley Medical Center in San Jose, Calif.

Experts debate the risks and benefits of hormone replacement therapy, but everyone, including the U.S. Food and Drug Administration (FDA), agrees that it definitely helps with two conditions: the symptoms of menopause and osteoporosis.

Here are the pros and cons for using hormone replacement therapy as well as some alternatives.

Hormone Replacement Therapy & Disease Prevention

Hormone replacement therapy was once used to prevent cardiovascular disease, dementia, Alzheimer's disease, and other conditions. But it is rarely used that way now. In at least some women, it may increase the risks of these conditions.

Some doctors use HRT in cases where a woman has a combination of symptoms that hormone replacement therapy can relieve. For instance, while using HRT for osteoporosis alone is not generally recommended, it may be used in a woman who has osteoporosis and other conditions.

"If a woman in early menopause has low bone density, high cholesterol, mood changes, and sleep problems, she could just take one medicine -- estrogen -- instead of four," says Lynne T. Shuster, MD, director of the Women's Health Clinic at the Mayo Clinic in Rochester, Minn.

The key is to work closely with your doctor. Before deciding on hormone replacement therapy, go over the specific risks and benefits in your case. Keep in mind your age, lifestyle, and risk for disease. Then get regular checkups to make sure that you should continue with HRT.

SOURCES: American College of Obstetricians and Gynecologists web site, "Frequently Asked Questions about Hormone Therapy, "News release: ACOG Issues State-of-the-Art Guide to Hormone Therapy." Shelley R. Salpeter, MD, clinical professor of medicine at Stanford University's School of Medicine; director of medicine consultation services at Santa Clara Valley Medical Center in San Jose, CA. Isaac Schiff, MD, chief of obstetrics and gynecology at Massachusetts General Hospital in Boston; chair of the American College if Obstetricians and Gynecologists Task Force on Hormone Therapy. Lynne T. Shuster, MD, director of the Women's Health Clinic at the Mayo Clinic in Rochester, Minn. U.S. Food and Drug Administration web site, "Questions and Answers for Estrogen and Estrogen with Progestin Therapies for Postmenopausal Women."