Hormone Replacement

Wednesday, August 3, 2011 10:43
Posted in category Prescriptions

Why is estrogen so important?
In addition to its role in reproduction, estrogen affects bones, blood vessels, the brain, and body tissue. That’s why estrogen loss can trigger more serious health problems such as osteoporosis (weak, thin bones).

Hormone Replacement (ERT or HRT):
Replenishing the body with estrogen is an important step in treating menopause. Your doctor can help relieve the menopausal symptoms your are currently experiencing… and help protect you from the long-term problem of osteoporosis by prescribing treatment in the form of estrogen replacements therapy (ERT) or hormone replacement therapy (HRT).

ERT contains estrogen alone. It is usually prescribed for a woman who does not have a uterus. HRT contains 2 hormones—estrogen and progestin. Estrogen therapy given alone can cause a buildup of the cells of the lining of the uterus (endometrium), increasing the risk of a condition called hyperpasia. If left untreated, this condition could sometime lead to cancer of the uterus. Adding a progestin to estrogen therapy helps to prevent overgrowth of the lining of the uterus, reducing but not eliminating this risk.

Is replacement therapy right for me?
After carefully reviewing all of your symptoms, medical and menstrual histories, and your risk factors for osteoporosis, you and your doctor can determine if replacement therapy is right for you.

What risks are associated with hormone replacement?
All estrogen-containing products raise the risk for blood clots and gallbladder disease. These effects are due in part to estrogen’s interaction with the liver. In addition, women who still have a uterus are at increased risk for uterine cancer if they are unopposed estrogen. The addition of progesterone to women’s estrogen replacement therapy essentially resolves this risk.

How does hormone replacement therapy (HRT) effect the risk if breast cancer?
Between the years 1975 and 1995 there have been 33 studies conducted to determine the effects if HRT on breast cancer. Twenty-five (25) of the studies found either no effect or decreased risk of breast cancer in women on hormones. Eight (8) studies found a slight elevation in risk fir breast cancer in patients who took hormones for over 5 years. Interestingly, in the patients who did get breast cancer, there was a 16% reduction in mortality for the estrogen users as compared to the women who were not on hormone therapy and developed breast cancer.

In summary, the preponderance of the evidence suggests HRT does not raise the risk of breast cancer with short-term use. It may however slightly raise the risk for breast cancer with long-term use. The Women’s Health Initiative Study, due to be completed in 2007-2008, should answer this question more definitely in the future.

Does 0.625 mg of Conjugated Equine Estrogen work?
In multiple scientific studies, 0.625 mg of CEE has been shown to relieve symptoms, to improve bladder and sexual function, lower the risk of cardiovascular disease (50% reduction) osteoporotic fracture (60% reduction), Alzheimer’s Disease (30% reduction) and colon cancer (50% reduction).

Are there alternatives to Conjugated Equine Estrogen (CEE) and/or medroxy progesterone (MP)?
While CEE/MP have been very effective for millions of patients, approximately 30% of women who take these medications eventually stop them due to side effects of fear of breast cancer. Over the last 5 years, several new hormone replacement therapies have become available. These include naturally derived estrogen/ progesterone/ testosterone pills, patches, and creams.

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