Trying to keep up with the latest on hormone replacement therapy (or 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.
Here are the pros and cons of using hormone replacement therapy, as well as some alternatives:
|Medical Condition||Pros||Cons||Alternatives to Hormone Replacement Therapy|
|Menopausal symptoms||Considered the best treatment for these symptoms (when severe), in women who are perimenopausal or postmenopausal.||Slight increased risk of breast or uterine cancer (risk is decreased for breast cancer if estrogen is used alone and for uterine cancer if both estrogen AND progesterone are used or if the woman has had a hysterectomy), and heart attack or stroke, in some women. May not be recommended for women who have a family or personal history of heart disease, stroke, blood clots, or breast cancer.||
Vaginal moisturizers, lubricants, vaginal estrogen
Treating each symptom directly.
|Osteoporosis (thinning bones)||Highly effective in reducing the risk of osteoporosis. May be good for women who cannot use other medicines that protect bone health.||Same as above.
Using hormone replacement therapy for prevention of osteoporosis alone -- not to treat menopausal symptoms -- is not recommended by the FDA. However, some women and their doctors may choose to use it for this reason.
Bisphosphonates, which reduce the breakdown of bone.
RANKL inhibitor (Prolia), which reduces bone turnover and resorption.
Hormone Replacement Therapy & Disease Prevention
Hormone replacement therapy was once used to prevent heart 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 for that reason.
"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.