Hormone Therapy and HRT: Making Decisions in the Face of Uncertainty

HRT society

Many women in today's society are seeking relief from the various uncomfortable symptoms of menopause. Hormone Replacement Therapy (HRT) remains a popular treatment worldwide. Various studies into HRT's success and potential risks are detailed below, and particular emphasis is given to analyzing its impact on quality of life.

HRT comes in many various forms, including estrogen plus progestin and estrogen alone. Because further scientific evidence is needed, it is not advisable for postmenopausal women to routinely use estrogen plus progestin to prevent chronic conditions such as heart disease. Similarly, insufficient evidence means that it is not possible to recommend postmenopausal women who have had a hysterectomy to use estrogen alone therapy or not, to prevent lasting conditions.

Whether or not women opt for HRT, making lifestyle changes to help reduce the risk of chronic diseases is vital. Evidence from the Women's Health Initiative trial indicates that women who choose to use HRT can reduce their risk of breast cancer by taking up more exercise.

Menopausal symptoms such as hot flashes are less of a worry than more serious conditions but can still hugely affect women's quality of life. HRT is known for its ability to alleviate menopausal symptoms and is particularly successful in relieving hot flashes and night sweats.

HRT unconfortable

Although researchers from the Women's Health Initiative trial report that estrogen plus progestin therapy did not impact on health-related quality of life, it was clear that women who received HRT were more likely than others to experience less severe hot flashes and night sweats.

Findings from this trial and other similar studies showed a reduction in hot flashes among older women (in their early 60s) using HRT. The Heart and Estrogen/progestin Replacement Study indicated that HRT in older women had differing effects on their quality of life; women who were relieved of hot flashes saw a decline in physical energy while those suffering from hot flashes saw an improvement in emotional actions.

Although HRT can produce side effects such as vaginal discharge, uterine bleeding, and breast tenderness, it does relieve some menopausal symptoms, such as hot flashes and is still considered an very efficient treatment.

Women who suffer intolerable menopausal symptoms such as severe hot flashes, and who turn to HRT as the most appropriate therapy should continue to do so, regardless of questions about its safety. Instead, these women should be educated about the common and potential health risks and benefits, so they can make an informed decision regarding its use.

Regarding the side effects of HRT, using data from the Women's Health Initiative trial, Grady estimates that around one major adverse event will occur in every one thousand 50-year-old women using HRT for a twelve month period.

While researchers from the Women's Health Initiative trial report that estrogen plus progestin therapy did not impact on health-related quality of life, it is evident that women using HRT will benefit from less severe hot flashes and night sweats, two common menopausal symptoms. Estimates based on data from this trial may exaggerate the risks of initiating the use of HRT in the early 50s as well as for women who use estrogen therapy alone after hysterectomy. A lot of women might be willing to accept this risk in exchange for relief from menopausal symptoms such as hot flashes. What is clear is that there are many uncertainties surrounding the role of HRT and so more research is needed, especially with regard to its impact on quality of life.