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Hormone replacement therapy, as the name suggests, consists of medical treatment that replaces diminishing hormones in the body whether given to men or women. The levels of the female hormones estrogen and progesterone decrease over the years, causing many discomforts.

For this reason, most women in menopause and after that period are the ones who receive hormone replacement therapy. Nowadays, there are a lot of young women and even girls with hormone imbalances, who have to use medications to boost their hormones.

Numerous risks and side effects have been reported over the years of HRT usage. Studies are yet to be performed on the true and accurate risks and health benefits of hormone replacement therapy compared to the other types of therapies that regulate hormone levels.

Negative Effects

Hormone replacement therapy is believed to have negative effects on the health of a woman's breasts. If progestin is combined with estrogen in the treatment (as in the medicine Prempro), it influences the breast tissue density which can indicate the risk for cancer. The therapy may cause dense breasts, which makes it hard for the mammograms to read the findings.

Women with dense breasts are at higher risk of developing cancer. Continuous use of such HRT for more than 4 years may be conducive to breast cancer. Estrogen alone does not have such a higher risk.

On the other hand, if estrogen is used without progesterone or progestin, there is the risk of endometrial cancer, i.e. cancer of the lining of the uterus. HRT may, to some extent, affect the development of the cancer of the ovaries.

Estrogen taken orally can make blood clots and increase the risk of cardiovascular diseases. Women who use oral estrogen and progestin are reported to have a higher risk of being struck with a heart attack. These results of the studies do not refer to the transdermal estrogen, the one delivered through the skin. Oral estrogen, as in Premarin, may also cause problems of the gallbladder.

Side Effects

Apart from the higher risks of getting certain diseases, hormone replacement therapy has several side effects. Women report vaginal bleeding in the treatment, including estrogen on daily usage and progesterone only a few times a month, but, also if both of these hormones are taken daily.

Doctors then adjust the dosage or type of medicine. It is common for women on HRT to feel pains in the breast and slightly nauseous. Gradual increase of the hormone levels can lead to mood changes and irritability.

Fluid retention is also one unpleasant side effect. Instead of taking pills, women can use transdermal hormones and some bio-identical hormones to ease the side effects. Women with some heart diseases or blood clots, breast or uterus cancer, and liver conditions should not use hormone replacement therapy.

Hormone replacement therapy (HRT) has been prescribed to relieve typical oestrogen deficiency symptoms, conserve postmenopausal bone and thereby reduce the risk of osteoporotic fracture, and also to reduce the risk of certain arterial diseases such as ischaemic heart disease (IHD).
  • Numerous placebo-controlled studies have confirmed that oestrogens reduce the frequency and severity of flushes and sweats, and also improve vaginal dryness. Although not consistent, some data report an improvement in psychological symptoms such as poor memory and concentration.
  • At appropriate daily dose, oestrogens reduce postmenopausal bone loss in both spine and hip; data on fracture efficacy from controlled studies at both of these sites are lacking, but observational data report reductions in fracture risk.
  • The effects of HRT in women with risk factors for IHD are controversial, with some studies reporting benefits but others not. The majority of the observational data in apparently fit and healthy younger women report an approximate 50% reduction in IHD with use of HRT.
✓ Fact confirmed: Hormone replacement therapy (HRT): indications and side effects M.I. Whitehead; 01 July 2002

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