Everything You Need To Know About Hormone Replacement Therapy

Between 45 and 55 years is the age that women usually feel the onset of menopause. As the body stops producing the hormones estrogen and progesterone, most of them start to present a series of symptoms that can impair their quality of life and health.

Hot flashes (hot flushes), weight gain and mood swings are some of the effects that make it difficult for women who go through this transition to be comfortable and social.

Climacteric — the scientific term for menopause — can also bring insomnia, reduced libido and memory problems, as well as increasing the risk of depression, osteoporosis and heart disease.

To circumvent these effects, a solution would be to take hormone replacement therapy, right? Not always! This depends on the particularities of each patient. Keep reading and understand the benefits and risks of this treatment!

Why Does Hormone Replacement Divide Opinion?

Although hormone replacement is recommended to alleviate the symptoms of menopause, as it replaces the substances that the body has stopped producing, care must be taken in the indication of treatment.

This is because not all women have health gains with this therapy, as, in some cases, there are risks in the process. The conclusion is from a North American study , the WHI (Women’s Health Initiative) , which investigated more than 16,000 women aged 50 to 79 years.

A part of them received hormone replacement therapy (estrogen and progesterone), while another group received only a placebo. The research found that the risks of the therapy were greater than the benefits. Here are some results with the group that received hormone replacement:

• 29% increase in heart attacks;
• 41% increase in strokes;
• 113% increase in pulmonary embolisms;
• 26% increase in breast cancer;
• reduced risk of bone fractures by 34%;
• reduced risk of colon cancer by 37%.

Another US study also pointed to the relationship between hormone replacement and increased risk of breast cancer and cardiovascular disease.

After All, When Should This Therapy Be Indicated?

So hormone replacement only harms health? On the contrary: many women can benefit from therapy. Therefore, the doctor must make an evaluation of each patient to know if this is the best indication.

Another point to be highlighted is that, precisely due to the risks, the recommended doses of hormones are usually small and the therapy time is reduced.

When Is There No Need For Treatment?

Many women can cope well with menopause without experiencing the unpleasant symptoms. So, in these cases, there is no indication of treatment. It is recommended that she perform some tests as often as necessary, such as the pap smear , to keep her health up to date.

Another recommendation is to follow the October Rosa prevention guidelines , performing tests that can detect breast cancer early, thus increasing the chances of curing the disease.

What Are The Contraindications?

In the case of women with stronger symptoms and more vulnerable to problems caused by the climacteric, the doctor evaluates the patient’s health history, as hormone replacement is contraindicated in cases of:

• women who have or have had some types of cancer that depend on estrogen for their evolution, such as breast or endometrial cancer;
• family history of breast cancer;
• acute thromboembolism or previous thromboembolism;
• vaginal bleeding or endometrial lesions;
• liver disease if the therapy is given orally.

What Precautions To Take?

Caution is needed in the indication of hormone replacement therapy in cases of:

• fibroids;
• ovarian cysts;
• suggested history of thromboembolism;
• smoking;
• obesity;
• large-caliber varicose veins.

Who Is Therapy Recommended For?

Healthy women who do not have cases that contraindicate treatment can take hormone replacement. This is a way to control and prevent diseases such as osteoporosis, as hormones can improve the uptake of calcium by bone tissue. In women with early menopause, therapy can reduce the risk of Alzheimer’s disease or delay its onset.

Therefore, the doctor indicates the dose and form of treatment according to the particularities and history of the patient. For those who have had their uterus removed, for example, treatment can be done with estrogen alone.

Starting therapy, it is recommended that the patient return to the doctor after about 2 months to make adjustments in the doses of hormones. After this period, it can be reassessed every 6 months.

Before and during treatment, the specialist requests a series of tests, such as blood, mammography , transvaginal ultrasound and bone densitometry, to monitor the woman’s health.

What Are The Ways To Do This Treatment?

The ways to take hormone replacement therapy are:

• orally — pills that contain synthetic estrogen and are taken daily;
• injectable — monthly or quarterly applications;
• transdermal — using patch and gel;
• vaginal ring — releases less hormones into the body and should be changed monthly.

What Care Should The Patient Have?

It is important that, before starting hormone replacement therapy, the doctor evaluates the patient’s complaints and health history. Only in this way will it be possible to know if the benefits of the therapy will outweigh the health risks.

When the woman is able to receive the hormones, she will certainly have an improvement in her quality of life, easing the unpleasant symptoms that appear with menopause.

In addition, medical follow-up throughout treatment and gynecological examinations are also essential to assess all effects. Maintaining a healthy lifestyle, with regular physical exercise and a balanced diet, also contributes to the success of therapy.

Hormone replacement is not a valid treatment for all patients, but it can be very beneficial for some women – as long as there is a careful medical evaluation. With the specialist’s guidance, the patient can make the best decision and go through this phase well, having quality of life and reducing the risk of a number of diseases.