Can HRT be part of a woman’s healthy lifestyle?
Hormone Replacement Therapy (HRT) has been used to treat menopausal women for many decades. It was believed to have many benefits in addition to addressing the familiar symptoms of hot flushes, night sweats, etc by protecting women from heart disease, cognitive decline, and the usual weight gain of middle age.
A study carried out in the USA, the 2002 Women’s Health Initiative (WHI) found there was an increase in the incidence of breast cancer, heart disease and blood clots among women taking HRT. The evidence was so powerful that they completely halted their study of HRT and told the women to stop taking it, as it was simply too risky. Women worldwide read these reports, as did their physicians, and many millions stopped taking HRT at that time. And, as a direct result, there has been a decrease in the number of new breast cancers reported.
Recently, however, there has been a rethink of this mass halting of HRT, mainly by the doctors who still need to assist women with menopausal symptoms. Many doctors now think that the benefits may outweigh the risks for women whose symptoms are considered moderate to severe. There has also been some criticism of the WHI study methodology because the women participating in it were aged from 50 to 79 years, with the average age of 63. But the average age of menopause is 51. The data has now been re-examined taking this age differential into consideration, and focusing only on the women under 60 who are, in fact, the ones most likely to need to take HRT for symptoms.
The new analysis revealed that among the women in their fifties who took HRT there was no increase in their risk of getting breast cancer. It was after more than 5 years of using HRT that the risk starts to increase. That risk is now seen to be comparable to that of women who have never had children, drink more than 2 alcoholic drinks per day, are overweight, or had a late menopause. And within 5 years of halting HRT their risk will have returned to normal.
Among the women in the younger group it was concluded that HRT use may in fact have reduced cardiovascular disease, reduced cervical and colon cancer, as well as reduced bone fractures related to osteoporosis. But if HRT was started when women were older, or already had cardiovascular disease, it could increase their heart disease. The new message seems to be as long as you start in your fifties and take it no longer than 5 years it is a safe way to treat menopausal symptoms. That said, it is always advisable to discuss your own particular medical profile with your doctor when making such decisions.