The debate on HRT continues

The risks and benefits of hormone replacement therapy (HRT) have long been a subject for debate. Now, a decade after the study that changed everyone’s opinion on HRT was released, there are even more questions on the safety and potential benefits of the treatment.

An updated review published in the journal Annals of Internal Medicine shows that some of the previous benefits shown in the original data haven’t held up over time, but the same can be said about some of the risks.

In the end, their recommendation remains the same. In most cases, there is very little medical reason a woman should take estrogen preparations after menopause to prevent bone fractures or chronic illnesses.

The drugs do help with some of the more uncomfortable symptoms of menopause — hot flashes, joint pain, night sweats, and insomnia — in some women, but the standing recommendation in Canada so far remains unchanged: these drugs should only be taken at the lowest dose available and for the shortest time possible.

The Canadian Task Force on Preventative Health Care has not looked into HRT since 2003, when their study on hormone use found that it puts women at greater risk for developing breast cancer, stroke and heart disease.

The follow up on the women who took part in the original study showed that it did not prevent colorectal cancer, as they had initially thought. Similarly, the women who participated in HRT did not actually have a significantly increased risk of cardiovascular issues.

The updated data did, however, show that women who take HRT are still at a higher risk of having a stroke.

The increased risk of breast cancer that initially stopped many women from taking HRT has been found to vary depending on the kind of HRT. Those taking estrogen and progestin saw a small increase in invasive breast cancer cases, up from 30 women out of 10,000 each year to 38 women.

For women who have had a hysterectomy and therefore only take estrogen, there appears to be a preventative effect, with only 22 out of every 10,000 women developing invasive breast cancer.

When the first report was initially released, hormone replacement therapy quickly fell out of favour. Over the years though, it has regained popularity in some cases for treatment of difficult menopause symptoms, but not for chronic disease prevention.

According to’s Women’s Health section, here are a few easy lifestyle changes to help ease menopause symptoms:

  • Be very conscious of your diet. Avoid caffeine and soda which increase bone loss. Limit your meat and sugar intake, and increase consumption of grains, nuts, fruits and veggies.
  • Consider taking red clover isoflavone supplements, which have been shown to help slow down bone loss, decrease hot flashes, and improve cardiovascular health.
  • Taking probiotics helps with metabolism and preventing yeast infections.
  •  Black Cohosh taken three times daily is said to help prevent many menopause symptoms.
  • Exercising regularly is vital in preventing bone loss as well as reducing risk for cancer and heart disease.

Sources: Annals of Internal Medicine, ABC, CTV, Women’s Health

Photo © Barsse

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