Is estrogen therapy recommended?
Dr. Lucia Gregoria is an internist and geriatrician at Banner Estrella Medical Center. Her office can be reached at (623) 873-1500.
Question: I have heard conflicting reports about estrogen therapy. Is it still recommended by doctors?
Answer: Hormone replacement therapy , often referred to as treatment rather than therapy, is a variety of medical treatments for surgically menopausal, perimenopausal, and to a lesser extent, postmenopausal women, to reduce discomfort caused by less estrogen and progesterone hormones in the body. It involves the use of one or more of a group of medications designed to artificially boost hormone levels.
Attitudes toward hormone replacement therapy changed significantly in 2002 with the announcement by the Women’s Health Initiative of the National Institutes of Health that the treatment (Prempro) they were using in their primary study coincided with a large incidence of breast cancer, heart attacks and strokes. Those findings were reconfirmed in a national study done in the United Kingdom. As a result of these two studies, the number of women taking hormone treatment dropped by almost half. Following the study, the Journal of the American Medical Association and others warned that women with normal, rather than surgical menopause should take any prescribed hormone replacement therapy treatment at the lowest feasible dose, for the shortest possible time. For health problems associated with menopause such as osteoporosis, other lifestyle changes and/or medications are now recommended.
Hormone replacement therapy is available in various forms. It generally provides low dosages of one or more estrogens, and often also provides either progesterone or progestin. In women who have had a hysterectomy, an estrogen compound is usually given without any progesterone. It may be delivered to the body via patches, tablets, crams, troches, IUDs, vaginal rings, gels or, more rarely, by injection.
Hormone replacement therapy is seen as a short-term relief (usually less than five years) from menopausal symptoms such as hot flashes, irregular menstruation, fat redistribution, etc. Younger women with premature ovarian failure or surgical menopause may use hormone-replacement therapy for many years, until the age that natural menopause would be expected to occur.