Is Hormone Replacement Therapy ideal for menopausal women?

Hormone replacement therapy was the medical raga about 30 years ago but now the latest doing the rounds is , “It’s complex; talk to the doctor.”

Hormone replacement therapy

In the past hormone therapy was thought to be the ideal way out from hot flashes and many age related diseases. The happy bubble was broken when the therapy started showing potential risk of breast cancer, blood clots and strokes. The conclusion of the researchers was that this therapy was fine for the women who reached their menopause at an earlier age than the elderly menopausal women.

The latest data obtained from a paper in the Journal of the American Medical Association states that long term hormone therapy for women in their late fifties is a “No-No”. The risks are more than the benefits of the hormone therapy. There are some women whose life is made hell by the agonizing night sweats and hot flashes, they can resort to short term hormone replacement therapy where the time period for the therapy is controversial and can extend to a period of a few years as well say the experts.

The research study

Science experts associated with the Women’s Health Initiative (WHI) Hormone Therapy Trials did a follow up study on almost 27,347 postmenopausal women in an estrogen plus progestin hormone trial and estrogen hormone trial . The two trials by the WHI insist that the hormone therapy is no the answer for chronic diseases and may just be considered in some women for system management. The women in the 50-59 years age group shpow more benefit than the elderly menopausal woman.

According to Dr. JoAnn E. Manson, the lead author of the new paper and chief of Preventative Medicine at Brigham and Women’s Hospital: “This is the most comprehensive evidence base available for clinical decision making and it does suggest that hormone therapy should not be used for long-term chronic disease prevention — but it remains an appropriate option for short-term management of menopausal symptoms in early menopause.”

Who needs it?

Talking about the young menopausal women and their medical state that disagrees for the therapy Dr. Manson said, “If a woman is at very high risk of cardiovascular disease — if she’s had a prior stroke or blood clots in her legs or lungs, or has multiple risk factors, she may not be an appropriate candidate for even short-term treatment. But most women who do have the very significant symptoms — of hot flashes and night sweats and interrupted sleep in early menopause — could be considered for short-term therapy to manage these symptoms.”

It’s only in the cases where the symptoms are extremely severe that one has to prescribe hormones but only 15-20% women account for this category.

Manson stated that “It is important to distinguish between the use of hormone therapy for symptom management and its use for the purpose of chronic disease prevention. Short-term use of hormone therapy to manage moderate-to-severe hot flashes or other symptoms in early menopause remains appropriate, and the WHI findings should not be used as a basis for denying women such treatment.” The treatment risks faced by older women was 4-5 times more than the women in 50-59 years.

Manson further concluded “Although studies of other hormone therapy formulations, doses and routes of delivery are needed to find treatments with fewer risks, these medications are now among the best studied treatments in medical history. Clinicians can share information from the WHI trials with their patients and help them make more informed choices.”