Risks and Benefits of Hormone Replacement Therapy

Hormone replacement therapy or HRT has been around for 25 years and is being used mostly to prevent and alleviate many ailments that arise in women after menopause. As such menopause and the attendant cessation of estrogen production are natural occurrences and don't need medical intervention.

However, some women suffer from menopausal syndrome in which the lack of adequate estrogen may bring on complaints of nervousness, fatigue, insomnia, depression, osteoporosis, muscle and joint pain, etc. If the complaints become persistent then the patient may need HRT. Below are some of the risks and many benefits of Hormone replacement therapy that women suffering from menopausal syndrome should be aware of.

For women many forms and types of hormone therapy are available, such as pills, patch, vaginal ring and gel. Of these, pills are the most popular and are of two main types; estrogen without progestin and a combined form of estrogen and progestin. Progestin is usually added to prevent the risk of uterine cancer in menopausal women whose uterus has not been removed surgically (hysterectomy).

Estrogen without or with progestin has been found to be effective in the control of night sweats, hot flashes and vaginal dryness in women. It has also been used to prevent the risk of osteoporosis in women suffering from menopausal syndrome. Thus it has been found to lower the risk of hip bone fracture in those women who have had hysterectomy.

Some studies suggest that hormone replacement therapy can prevent loss of bone mass in the post menopausal period, particularly in women who are at the risk of developing osteoporosis and/or cardiovascular problems. In fact some studies have suggested that the bone loss may even begin four years before menopause in women having irregular cycles. These studies even suggest that HRT should be started before menopause when the regualr menstrual cycles starts becoming irregular.

However hormone replacement therapy is not without its share of risks. In one study it was observed that in women older than 65 years estrogen increases the risk of possible dementia and a mild form of cognitive impairment. In some cases even short term use was associated with increased risk of stroke, blood clots and even coronary heart disease. There is also increased risk of getting breast cancer in those women who use HRT for 5 years or more. The side effects of estrogen use include the possibility of heartburn , nausea, vomiting, tenderness in breasts, uterine bleeding, weight gain and fluid retention.

Even though the benefits outweigh the risks the use of HRT should be strictly based on individual needs and the careful evaluation of the individual case.