Menopause is a natural part of every woman’s life, usually occurring in her 40s or 50s. During this time, I believe all women should seriously consider hormone replacement therapy because of its known benefits in treating and preventing heart disease and osteoporosis. However, some women may decide against it for good reasons.
Studies show that HRT dramatically reduces a woman’s risk of developing heart disease, the leading cause of death among American women. The drug also protects against osteoporosis, a weakening of bone structure that puts women over age 50 at significant risk for fracture.
A recent study also suggests that HRT may reduce the risk of Alzheimer’s and improve short-term memory in patients with Alzheimer’s. While it’s clear from animal studies that hormones directly affect brain function, their effects on the human brain remain mostly elusive.
The way HRT works is simple. The drug, generally administered in pill form, replaces the hormones a woman’s body stops producing once she’s gone through menopause.
For more than 50 years, doctors have prescribed HRT to treat the hot flashes, vaginal dryness and insomnia that accompany menopause. There are, however, some downsides to HRT. These include an increased risk of breast and endometrial (uterine) cancer.
Fortunately the risk of endometrial cancer is fairly low now because physicians tend to prescribe estrogen in combination with progestin, a hormone that lowers the risk of endometrial cancer.
For a woman with a personal or family history of breast cancer, however, HRT may not be a good option. Any woman who chooses HRT should have her breast health carefully monitored by her physician through scheduled mammograms, breast self exams and regular physician appointments – even if she isn’t at high risk of developing the disease.
A woman at high risk of developing osteoporosis may have a strong incentive to take HRT. Women at high risk include those with family histories of the disease, small frames, calcium-poor diets and those lacking regular exercise regimens.
I’m a strong proponent of HRT, but it’s not for everyone. Every woman should discuss it with her physician and carefully weigh the benefits and risks.
Clewans is an endocrinologist at the Palo Alto Medical Foundation. Dasmalchi is a consultant and writer.
