There has been so much talk about hormone replacement therapy in recent years and so many contradictory theories that many clinics have started systematic research on it. Thanks to this, many doubts were dispelled. Check the advantages and disadvantages of hormone replacement therapy.
Hormone replacement therapy( HRT ) has itsadvantages and disadvantages . The average woman enters perimenopause at age 51, and the last period usually occurs between the ages of 45 and 55. Late menopause is when the last period occurs between the ages of 55 and 60. Early age affects women who have stopped menstruating between the ages of 40 and 45. But regardless of when the menopause comes, every woman then faces the dilemma of whether to start hormone therapy (TH). Many women are afraid of hormones because they are convinced that they bring more losses to he alth than benefits, e.g. that they promote cancer and thromboembolism. But the conclusions of the research do not confirm this. However, they prove that there is no one optimal form of therapy for all women. Treatment must be selected individually.
Hormone therapy - the sooner the better the results
It is already known that the use of estrogens does not increase the risk of coronary artery disease in he althy women after recent menopause. Following the publication of the results of the Women's He alth Initiative (WHI) study in the United States, which emphasized that TH promotes coronary heart disease, the collected data was re-analyzed. It turned out that TH worked badly, but only for women over 70 years of age. When used before the age of 60, it inhibits - and in many cases even reverses - the process of vascular calcification, improves the structure and functions of blood vessels, can lower the level of triglycerides in the blood and reduce the risk of type 2 diabetes. Estrogen deficiency promotes atherosclerosis, hypertension, and abdominal obesity. As a result, it increases the risk of coronary heart disease and heart attacks in postmenopausal women, one of the leading causes of mortality during this period.
The use of hormone therapy in obese and very advanced women increases the risk of thromboembolism and stroke by 2-3 times. In women immediately after the menopause, the therapy does not increase the risk of stroke, but it was introduced after the age of 60life may be its cause.
Hormone therapy causes beneficial changes in lipids (it lowers the concentration of total cholesterol and LDL fraction, and increases the concentration of HDL fraction). It has also been proven that better results are achieved with oral administration of hormone therapy than when it is administered, for example, from patches. As a result, TH prevents atherosclerosis, improves blood circulation and blood supply to tissues. As a result, the risk of heart disease is reduced by 35-50%. But if started too late - many years after your last period - it can increase your risk of blockages and clots. It has been proven that such a risk can be caused by high doses of estrogens - taking small, individually selected doses does not carry such a risk.
Most women fear breast cancer more than any other type of cancer. This view was reinforced by the aforementioned WHI studies, which were in fact carried out in a group of women over 65 years of age. It is now believed that the risk of breast and endometrial cancer may increase after 7 years of estrogen-only use. But the risk can be minimized by administering progestogens at the same time. There has also been an end to disagreement that breast cancer is caused only by hormone therapy. Today, no one doubts that menstruation before the age of 11, late pregnancies (over 35), obesity (BMI between 30-35), excessive drinking of alcohol and a diet rich in saturated fatty acids are also of great importance here.
Or maybe estrogens in patches?
Many women choose patches when opting for hormone therapy. They are comfortable - they are glued on every few days, they are durable, they will not come off, for example, during a bath. These modern preparations very precisely release the hormones they contain, keeping their concentration in the blood serum at a certain, uniform level. They also have a beneficial effect on the lipid metabolism ( although not as strong as in the case of oral therapy). Transdermally applied estrogens cause a significant reduction in the concentration of harmful LDL fraction and thus in total cholesterol in the blood. However, they do not cause significant changes in the level of HDL and triglycerides.
HRT protects against osteoporosis
Premature menopause (before the age of 40) and early menopause are associated with an increased risk of osteoporosis. Therefore, along with lifestyle changes, gymnastics, quitting smoking, weight control and supplementing vitamin D deficiency, hormone therapy is introduced, usually in small and ultra-small doses, smaller than that administered in standard therapy. What does it do? A woman loses bone mass more slowly and is better protected against fractureship joint and vertebrae. However, this does not apply to women over 60 years of age. In them, hormone therapy to prevent bone fractures (including the femoral neck) must be selected individually, taking into account many other diseases.