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Hormone therapy. Some women use it as a personal Fountain of Youth. Others rely on it to prevent unwanted pregnancy. Either way, the end results are good—and bad. Learn the benefits and the risks… Read more

 


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The Truth About Menopause & Hormone Replacement


As most women approaching (or in) menopause already know, much more than your monthly periods are affected. In an attempt to maintain its menstrual cycles, a woman’s body goes through dramatic fluctuations in both estrogen and progesterone production. The notorious results: hot flashes, mood swings, headaches, sagging skin, vaginal dryness and often the onset of osteoporosis.

 

A decade ago, most women who knew about hormone replacement therapy (HRT) opted to take advantage of it.  And their doctors strongly encouraged them to do so. Essentially, HRT turned back time. Women looked younger and felt better than they had in years. At least as important, they maintained their bone density and protected themselves from the bone loss that can lead to hip fractures after menopause. As long as women remained on an HRT regimen, their estrogen levels actively helped keep bone mineral density higher than women not on HRT, who were two-thirds more likely to suffer a fracture due to osteoporosis.

 

Then in 2002 the National Institute of Health released findings of their landmark study, conducted by the Women’s Health Initiative. The results showed a profound increased risk for breast cancer, heart disease and stroke in women taking hormone therapy drugs. It’s estimated that since that time, 75% fewer women have initiated HRT.

 

Some doctors in the clinical world remain skeptical and many have accused the NIH findings of being more shock than substance. That has only made it more difficult for women to know who to trust or what to do. Yet as recently as November, 2010, researchers from the University of California San Francisco published findings in the Journal of Clinical Oncology, correlating the decline in breast cancer over the past decade at least in part due to the decline in HRT by women in menopause.

 

There is no easy answer. For example, what’s the more powerful statistic—that estrogen plus progestin hormone regimens increase stroke risk by 41%; or that they decrease risk of hip fracture by 34%? It is a tough call and necessitates that a woman consult carefully with her gynecologist to balance all the variables, which include weight, blood pressure, bone density and your family history of breast cancer.

 

Why Women Gain Weight After Menopause

 

The Future of Hormone Contraceptives

 

As recently as 2008, the research organization Guttmacher Institute found that only 28% of fertile women were using the pill for birth control. To put that percentage in proper perspective, 27% of women instead had chosen tubal ligation!

 

The science behind the pill is somewhat similar to the science behind hormone replacement therapy for menopausal women. Essentially, the pill gives fertile women alternating doses of estrogen and progesterone. By introducing this “extra,” the drug essentially tricks the body into thinking it’s already pregnant. So ovulation stops and without ovulation, pregnancy becomes impossible.

 

If you haven’t already heard, the pill is increasingly prescribed to solve problems other than unwanted pregnancy. Conditions like endometriosis, problem skin and acne, and painful periods—not to mention evidence that they may reduce the risk of ovarian and cervical cancer later—they’re all reasons why doctors are putting women on oral contraceptives.

 

Yet widespread and long-term use of hormone therapy contraceptives is beginning to see some backlash. And more and more women are reportedly opting for alternative methods, treatments that avoid the pill’s controversial relationship with blood clots, depression and weight gain.

 

Just two years ago, the Center for Disease Control found the percentage of women choosing the pill for their first premarital sexual encounter has decreased by almost half.  Some women’s health advocates argue that the change may have less to do with women’s shifting attitudes toward the pill and more to do with the limited choices offered them by state health coverage.

 

Either way, the question remains: over time, what role will hormone options play in the spectrum of contraceptives?

 

 
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