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The Pros and Cons of HRT

Hormone replacement therapy was seen as a cure all for menopause symptoms like hot flushes, sleep disturbances, vaginal changes, as well as for the treatment and health of your bones and heart. The pros and cons of HRT therapy were still shrouded in mystery and the wonder drug was put on a pedestal as a fail safe. The reputation and glory that HRT enjoyed was unfortunately short lived as it's risks and benefits were dug into deeper by researchers. 


The year was 2002 when the Women's Health Initiative (WHI) unearthed the pros and cons of HRT after menopause symptoms start, through a long term study conducted on women between the ages of 50 and 79. 


The main point of the study was to discover if the use of oestrogen or oestrogen combined with progestin, had any effect on prevention of heart disease in women. Since these were the two hormones used extensively and prominently at the time, they were chosen to be the focus of the study. The study conducted with the combination of oestrogen with progestin was put to an end 3 years prior to the date it was supposed to end due to an increase in the risk for breast cancer, heart disease, stroke and blood clots in the lungs in the subjects used in the study. Instead of relieving menopause symptoms, these therapies were reported to be highly dangerous.


After the pros and cons of HRT for menopause symptoms, backed with solid scientific research, was made public there was widespread panic and a distinct drop in the number of women opting for HRT. Alternative treatments were sought and there was a rise in all forms of non-hormonal as well as natural treatments. A few years later the oestrogen treatment also saw a similar end when it was found that supplementing your body with the hormone not only increases your chances of stroke, but also had no cardiovascular benefits. It was therefore concluded that hormone therapy did more harm than good and was promptly put on the back burner to stew until it could be modified or put to better use. 


After been dropped by society for a period of time as being useless to relieve menopause symptoms, researchers stumbled across lonely desolate HRT again and began their research into it anew. They weighed the positive and negative effects of hormone treatment researched by the WHI and discovered that the results initially presented to the society were not as deadly (no pun intended) as they first seemed to be.


This batch of experts realised that the subjects used in this study were on average 64 years old, almost 10 years older than women going through perimenopause and menopause symptoms. It was also observed that if women chose hormone therapy, the risk of coronary heart disease went down by 30 percent.


The fact that the pros and cons of HRT treatment as seen in the results of the WHI, did not in reality lean to the side of cons as heavily as was initially hinted at. This was impressed on the doctors and through them the women, who were then able to approach HRT with a semblance of comfort and faith in the medicine. It was further revealed that oestrogen therapy had no increased risk of breast cancer. Oestrogen only therapy is usually prescribed for women who do not have a uterus.

Oestrogen therapy for menopause symptoms come in different shapes and forms and leaves you with a number of decisions to make. Pills, patches and many more form the array of options to choose from. The form of therapy that works better for you might not make a dent in the menopause symptoms of another woman. It all depends on your preference, the specific menopause symptoms you might be suffering from and their intensity, as well as the results you might be aiming for. There are two forms of HRT to treat your menopause symptoms depending on whether you still have your uterus. After weighing the pros and cons of HRT after hysterectomy (a procedure in which part or the entirety of your uterus is removed), a treatment plan of just oestrogen is recommended. In case you do have your uterus while going through menopause symptoms, a combination of oestrogen and progestin is the preferred course of treatment.

Different types of oestrogen replacement therapy

HRT Pills

Oestrogen Replacement Therapy for menopause symptoms is most often given in the form of pills like Premarin and Estrace. It is advisable to follow the instructions of your doctor. There are a number of pros and cons of taking HRT therapy through pills. HRT through pills provide relief or show a distinct drop in the severity of your menopause symptoms. It also helps lower the probability of developing osteoporosis. HRT through pills is usually opted for due to the extensive research that has been done to observe it's risks and benefits.The pitfalls of oestrogen therapy have been well documented and advertised. Oestrogen is known to add to the risk of strokes and blood clots, along with a number of other problems. If you still have your uterus and have been recommended to take progestin along with oestrogen, it elevates the risk of breast cancer and heart attack. It also comes with its gift hamper of breast pain and swelling, vaginal discharge, nausea and headache. People with liver damage are advised not to take the oral form of oestrogen, no matter how bad your menopause symptoms might be, as it can be really hard for the liver to process. Absorption of the oestrogen that you ingest might also be troublesome if it clashes with any of your other medications. Due to the fact that it is metabolised in the liver, there is a possibility of your cholesterol spiking.


HRT Skin Patches

Alora and Estraderm are some of the examples of oestrogen therapy through skin patches. A skin patch is usually applied on the lower part of your stomach. It is not needed to change it daily. Once or twice a week, is usually prescribed by medical professionals. A patch is better than the pill in the sense that once you have it on, you do not have to think about it all day. You do not have to remember taking it like a pill. Ingestion of oestrogen is detrimental to the liver, the patches on the other hand do not pose the same dangers. A patch also doesn’t cause blood clots like oral oestrogen can. Although there are some preferences seen in patches rather than pills, there is no concrete proof as of yet. So all forms of oestrogen therapies come with the same warnings.


Oestrogen patches should not be exposed to severe heat or left exposed to sunlight. Heat might make the patches release most of the oestrogen early on and then leave little for later. So it is advisable to not expose your body to high heat when you have the patch on. 

HRT Gels and Creams

It is similar to skin patches when the oestrogen is absorbed directly through the skin and into your bloodstream. This helps avoid any contact with your liver, keeping it absolutely safe from the side effects. How, when and where, these products have to be applied might differ, although most are recommended to be applied once a day. Introducing oestrogen into your body through these forms are not well researched, so it is to be assumed that they hold the same risks as other forms of oestrogen therapies. It is important to apply it only after bathing and to let it dry before you put your clothes on.


HRT Vaginal Rings, Creams And Suppositories 

These can be applied directly to your vaginal area to gain relief from menopause symptoms. Vaginal dryness, itchiness, discomfort during sex, as well as other menopause symptoms focused around the vaginal region can be helped by this form of oestrogen treatment. The dosage depends on the product or the advice of your doctor. Vaginal rigs have more durability than skin patches. So it needs to be removed after around 3 months. Since you do not have to take it daily it is more convenient than pills. Since these rings are known to have low dosage and affect only the surrounding area, it can be used for menopause symptoms such as vaginal dryness without your entire body being subjected to it. This makes it a safer alternative.


The same things that make it a desirable option can also be considered a con. The rings are beneficial to reduce or get rid of vaginal menopause symptoms. However it might not have the same effect on the other menopause symptoms due to its low strength and being centered only on one area. These forms of oestrogen therapy are not recommended for long term use, especially for women who still have their uterus intact, as there is a possibility of contracting endometrial cancer. 


Every woman is different and goes through the journey of menopause and it's consequent menopause symptoms in her own way. The research on hormone replacement therapy is still ongoing. While oestrogen therapy in pill form has been well researched, the positive and negative effects of hormone therapy through creams, vaginal rings, etc is still for the most part obscure. Due to the limited amount of literature on the pros and cons of HRT treatment, a low dosage of oestrogen for the shortest period of time is recommended. Obviously a doctor must be involved in your decision making where HRT is concerned.


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