The Risk of Hormone Therapy and How My Wife Deals with It

Immersed in a perpetual perimenopausal storm with constant body changes and moods becoming more and more erratic, my wife had ceased to be the woman I had once married. None of the feel better tricks and weight loss strategies which she had used for years did anything to help her. The predictable changes of menopause were all there and that she understood. However, understanding the physiology of what was happening to her body was one thing, handling it emotionally was another. There was a time when we use to joke about hot flashes, not anymore. Nothing from the doctor or the health food store curtailed her symptoms. She was becoming desperate and had to give some serious thoughts to the use of synthetic hormones.

Hormone therapy was something she would never consider. The risk of cancer in exchange for a better day to day existence suddenly became a risk worth taking. For her, it was a decision to save a life (hers and mine together) rather than endanger it. Her hot flashes went from mild to extreme in minutes. Many nights I would awaken as the furnace like heat engulf the bed followed by sweat soaked sheets and pillows which chilled the bed. The energetic, charismatic, confident women I knew and loved had transformed into a cranky couch potato. Her sex drive had disappeared. Her skin and hair were becoming dry and unsightly. She was also gaining weight which placed her in a constant state of high anxiety.

Initiating healthy lifestyle changes, which is suppose to be the best defense against these types of symptoms, did nothing for her. Going to bed earlier and some support group involvement did help her cope a little better emotionally, but something more was still needed. The low risk menopausal fixes were not bringing her the relief she was seeking. That is when she began to be more opened mind to hormone therapy (HT). It was not an easy decision for her. She felt a little betrayed having to acknowledge she could not get through perimenopause with healthy habits and lifestyle alone. We begin researching HT, the treatments available and the safety factor.

Hormone therapy still remains the best way to curb hot flashes and other uncomfortable menopausal symptoms. As far as safety is concern that depends on how old you are when you begin the therapy. The current medical thought is the further away from menopause you are when you begin HT the more negative health effects you may suffer, therefore the closer you are, the more positive impact the therapy may be. The breast cancer risk increases with the length of time you continue to use HT therapy. The North American Menopause Society reports women should stay on hormone therapy for only 5 to 7 years to reduce their risk of developing breast cancer.

Hormones which incorporate conjugated equine estrogens (estrogens from pregnant mare's urine) are very popular and have been in use for years. They contain components that do not have a chemical structure similar to human estrogens which cause complications in some women. There are two bioidentical HT she was considering that uses estrogens and progesterone identical to human hormones. The pharmaceutical version of one of the bioidentical HT is FDA-approved. A customized version is also available. Known as compounded bioidentical hormones, very few studies and comparisons are available on their effectiveness because they are prepared only by specialized pharmacies. She ruled out the compounded bioidentical HT for the FDA-approved therapy.

She began with a low dose estrogen (0.05mg daily) and progesterone (100mg daily) regiment. It is recommended women who still have their uterus take both. There is a risk of blood clots with this therapy so she elected a non oral estrogen delivery system via a vaginal ring. These dosages are less than that found in most birth control pills.

Within a few weeks, signs of my old wife were beginning to reappear. The hot flashes reduced significantly and the desert /arctic night experiences ended. Her quality of sleep improved and she begin talking about having dreams again, something I had not heard her mention for sometime. Her hair, skin and nails returned to normal, her energy surged, and her sex drive started returning. There was one down side however, her appetite increased and so did her weight. But after a while even that got back under control.

She continues to work with her doctor to tweak her dosage as needed. She has accepted that she may have to continue hormone therapy for the long term in order to maintain the benefits. Some women are able to stop or taper off HT after a few years with no returns of the symptoms. She and her doctor have agreed to wait until she has gone a full year without a period and reassess. If the symptoms do not return she will stop. If they do she is okay with return to hormone therapy.

The improvement and return of the quality of her days made the risk worth it. Her doctor has explained to her as long as her risk profile does not change significantly she can stay on her present path. Periodically they reevaluate things and stay abreast of new research. She is still concern about the risk and dangers of HT but she is not losing sleep over it. The benefit of being able to maintain a vital life means far more to her than the risk of possible consequences. To reduce some risk she works out regularly, eats right and avoids secondhand smoke. Who knows, she says, something may come along soon which may reduce the risk associated with hormone therapy.

Resource: Personal Experience