Hormone Replacement Therapy for Postmenopausal Women

The majority of women will experience menopause between the ages of 45-55. Menopause is a natural process that is defined as the time period when women stop menstruating. During this time women may develop hot flashes, chills, night sweats, sleep problems, mood changes, and vaginal dryness. Symptoms are caused by a decrease in estrogen, a hormone that plays an important role in the normal reproductive development of women. Since the 1970s, over 600 million women in the western world has used hormone replacement therapy (HRT) as a treatment for these symptoms.

Women experiencing menopause can have symptoms so severe that they impact sleep and their ability to function. Treatment with HRT can help relieve these symptoms and improve quality of life for women. Despite the ability of HRT to improve life for women suffering from symptoms of menopause, the treatment is not for everyone. In 2002, the Women’s Health Initiative (WHI) published a study that concluded that post-menopausal women receiving HRT had an increased risk for breast cancer, heart disease, stroke, blood clots, and urinary incontinence. Despite recent research that concludes that HRT is safe for young postmenopausal women, the use of HRT to treat women experiencing symptoms of menopause remains controversial.

Current guidelines for using HRT to treat women with symptoms of menopause state that HRT should be used for women with moderate to severe symptoms that impact sleep, quality of life, or ability to function, and who are less than 60 years old. These guidelines also conclude that physicians and their patients should make sure the benefits of treatment outweigh the risks. For this reason, women with a history of breast cancer, coronary heart disease, a previous stroke or thrombotic event, active liver disease, or those at high risk for any of these complications should not receive HRT in any circumstance. Also, current recommendations state that women on HRT should be on the lowest dose possible to treat their symptoms and should stop or taper treatment after four or five years to avoid increased risk of adverse effects.

Since the WHI published their findings in 2002 the use of HRT in the United States has dropped by 80%. This can be attributed to the possible adverse side effects that are associated with the treatment. But more recent research shows that HRT may be an option for some women looking to get relief from their symptoms of menopause. It is important for women struggling with symptoms of menopause to seek advice from their physician about HRT and other possible treatments to better improve their quality of life.

References:

Martin, K. (October 7, 2022).Treatment of menopausal symptoms with hormone therapy. In: UpToDate, Lockwood CJ (Ed), UpToDate, Waltham, MA (Accessed on October 25, 2022.) Retrieved from Treatment of menopausal symptoms with hormone therapy - UpToDate