Truce! Finding the Middle Ground on Hormone Therapy
10/2/2017 10:36:12 PM
HRT

Hormones and the news about hormones have one thing in common: they tend to wildly fluctuate. For years, many women went on hormone therapy upon reaching menopause as a common way for controlling symptoms such as hot flashes, emotional highs and lows, risk for osteoporosis, and many others.  

A large clinical trial raised questions about the risks causing doctors to become less likely to prescribe it. However, further review of clinical trials and new evidence showed that hormone therapy could be a good choice for certain women, depending on their risk factors. 

"Hormone therapy isn’t right for every woman,” said Scott Bergstedt, MD, Ob/Gyn with OBG-1 of West Calcasieu Cameron Hospital. "But many health experts agree that it shouldn’t be avoided as was done immediately after the findings of the study were released. We’re still feeling our way through and we know that we don’t have a concrete answer yet; but the fact is that there are definitely women who benefit from it.”  

The problem with this new territory of middle ground is that it’s hard to know when hormone therapy is appropriate and when it’s not a good idea. To clear up some of the confusion, Dr. Bergstedt described some situations where it could help.  

Hot flashes and night sweats. "The level of hot flashes can help determine whether we use hormone therapy or not,” explained Dr. Bergstedt.  "Probably two thirds of women report mild to moderate hot flashes, saying that they are annoying, but not severe. In these cases, they are able to alleviate the symptoms on their own, by layering clothes, avoiding spicy foods, using breathing techniques when the hot flashes occur, and generally try to ‘make do’ without using medication. I agree with this approach. If they are able to get through these times on their own, I think that’s best; but, a few women have severe hot flashes and night sweats. It interferes with their sleep and daytime activities to the point that they can’t function normally. In these cases, hormone therapy can help. A high percentage, probably around 95%, of women who suffered with hot flashes said hormone therapy greatly reduced their symptoms.”

Sleeplessness is often related to night sweats, but can also occur on its own. When it occurs for a span of time and interferes with the next day’s activities, it’s probably time to check with your doctor.

Osteoporosis has been shown to improve in women on hormone therapy, but not across the board. Older women who have osteoporosis may not see as much of an improvement as a younger woman in early menopause with osteoporosis. This is where family history and individuality comes in the picture. "The physician has to look at each patient individually and then together, they can decide on a course of treatment,” said Dr. Bergstedt.

An overall boost can be a legitimate reason for hormone therapy. Some women just feel better when taking the hormones. "In these cases, I would make sure my patient understood the risks associated with it, and that they agree to come in for regular check-ups and have the recommended screenings,” he said. 

Health experts do agree that keeping it short and simple is still the way to go: take the lowest dose possible for the shortest amount of time. Defining a short amount of time can be tricky. Again, it depends on the individual. Dr. Bergstedt suggests the patient bring it up during regular check-ups.  "It’s good to address it at each visit,” he said. "Your physician shouldn’t gloss over it; he or she should talk with you about it, see how it’s making you feel, ask about any unusual symptoms. It is something we should continually monitor.”

The decision to go on hormone therapy is one that should be discussed with your doctor after understanding the potential risks involved; but it’s not the taboo treatment some make it out to be. Women are discovering that middle ground can be a comfortable place.
Posted by: Christine Fisher | Submit comment | Tell a friend

Categories:

Share and enjoy: Del.icio.us   Google Bookmarks   Reddit   Technorati   Windows Live Bookmark
Categories: