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  • Hormone Replacement Therapy

    If you're a woman approaching menopause, you've probably considered hormone replacement therapy (HRT), a combination of estrogen and progesterone or estrogen alone. Of all the options out there, HRT may seem the most appealing—at least immediately. A pill to cool the hot flashes or a patch to take the nightmare out of night sweats? If it sounds too good to be true, it just may be. For all the relief it may provide, HRT comes with its own set of risks to consider.

    HRT is thought to increase the risk for heart disease. “Wait,” you might be thinking, “I thought HRT prevented heart disease!” You aren't alone in that—doctors used to prescribe HRT as a preventive medicine, thinking that it decreased the risk for cardiovascular disease, which becomes increasingly common as women age. Now, however, doctors think HRT may put women at a higher risk for that very problem.

    Heart disease isn't the only health concern that plagues HRT. Breast cancer is also a worry for women taking hormones. In fact, in 2002 the Women's Health Initiative halted its study because of indications that HRT placed women at a greater risk for breast cancer. A dramatic decrease in HRT prescriptions followed. The New York Times reports that in 2001 prescriptions for the two most common HRT drugs numbered 61 million but by 2004 that number had dropped to 21 million. While HRT prescriptions dropped, breast cancer diagnoses did the same, falling seven percent overall and fifteen percent in cancers stimulated by estrogen. Estrogen may act as fuel for some cancers, while progesterone may work indirectly.

    Women should speak to their doctors to determine if the benefits of HRT outweigh the risks. A woman who suffers from debilitating hot flashes, for example, might require the relief that HRT can provide. If a woman is at a higher risk for breast cancer, she and her doctor may decide that HRT is not the safest option.

    If a woman makes the decision to take hormones, she should also pay careful attention to how she takes them. Options include oral ingestion, skin patches and vaginal rings. A doctor can help a woman decide which method will best alleviate her symptoms. “If a hormonal approach is chosen, the lowest possible dose of HRT should be prescribed for the shortest time period,” advises Randall Rosenthal, MD, obstetrician and gynecologist at Newport Hospital.

    Some women may shun hormones and turn to other “‘remedies' available on the Internet and in stores that are advertised as ‘natural,'” Rosenthal notes. While these women may think they are making the healthy choice, just the opposite may be true. “Most of these products are untested and unregulated. Therefore, they may be a waste of money at best and a health threat at worst,” warns Rosenthal.

    Menopausal women have more coping options than ever before, from hormones to lifestyle changes to support groups, which dot the Internet landscape. Every woman should be able to work with her doctor to determine which treatments will allow her to most enjoy what may be the best years of her life. “The best years?” you might grumble skeptically as you feel a hot flash coming on, “yeah, right.” But why not? The kids are out of the house, retirement is in sight—what's not to love?

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