Hormone replacement therapy for menopause

 I must admit that I’m not much interested in menopause these days. Been there; done that. But menopause was tough for me: mostly the hot flashes, awful night sweats, and weight gain (ten pounds, seemingly overnight). I sought medical help.

There are those who object to “medicalizing” menopause—turning previously nonmedical problems into medical ones. While I generally lean toward this attitude, where menopause is concerned medicine can help. Besides, it wasn’t until 1908 that a woman’s life expectancy topped 51, which is the average age of menopause onset. In other words, it didn’t used to be an issue. Today, American women can spend a third or more of their lives in this state. In an AARP survey, 84 percent of women say their symptoms interfere with their lives.

What to do? Hormone (estrogen) replacement therapy seemed to be the solution until 2002 when researchers discovered that under this standard of care, which was combination of estrogen and progestin, significantly more women were dying of heart attack, stroke, blood clots, and breast and ovarian cancer. Later, it turned out that the early interpretations of this data had been partially wrong—mostly because those women over 60 who had started hormones more than a decade into their menopause were already suffering from such diseases. In fact, in an 18-year follow-up study, researchers found that women ages 50 to 59 who took hormone replacement therapy had a lower mortality rate than those who were not taking hormones. (Incidentally, there are estrogen receptors on every organ in the body.)

Now it appears that hormone replacement therapy, when properly applied for an appropriate period of time, can have wide-ranging benefits. One study, in London, indicated that postmenopausal women on hormone replacement therapy for an average of eight years had better cardiac health than those not receiving the therapy. The current thinking is that hormone replacement therapy should be used primarily as a short-term solution for symptoms of menopause. That’s what I did and I’m OK.

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