Hormone
replacement therapyWhat is the menopause?
As a woman gets older her ovaries produce less of the female hormone oestrogen. This causes many symptoms (see below) as her body adjusts to doing without oestrogen. This tends to be called the menopause, although strictly speaking this is the last time that a woman has a period.
Menopausal symptoms and effects
| Hot flushes | Night sweats |
| Sleeping problems | Fainting episodes |
| Palpitations | Headaches |
| Fatigue | Anxiety |
| Forgetfulness | Mood swings |
| Difficulty in concentrating | Loss of sex drive |
| Difficulty in making decisions | Discomfort during intercourse |
| Discomfort on passing urine | Vaginal dryness |
Before the menopause oestrogen also protects women from some serious diseases. After the menopause the risk of fractures of the hip, heart attacks and strokes all increase.
What is hormone replacement therapy?
As the name suggests hormone replacement therapy simply replaces the oestrogen that the body is no longer producing. It can be taken as a daily tablet, worn as a patch, rubbed on as a cream, or actually implanted into your skin.
Possible benefits
- Relief of the menopausal symptoms listed above
- Osteoporosis (thinning of the bones) - risk of fractures reduced
- Coronary heart disease - risk may be reduced
- Stroke - risk may be reduced
- Senile dementia - risk may be reduced
Some benefits of HRT are clear, others have not yet been fully evaluated scientifically.
Problems
- Menstruation and premenstrual symptoms
The womb must not be exposed to oestrogen alone as this would cause the lining to build up continuously and could lead to pre-cancerous changes. So once a month, for just over a week, women who have not had a hysterectomy need to take the other female hormone progesterone in tablet form. This mimics the body's natural cycle and usually produces a menstrual bleed, although these tend to be lighter than those experienced earlier in life. Some women also experience premenstrual tension, but this can usually be overcome by trying different forms of progesterone. - Clotting Problems
Recent research has shown that their is a small increase in the incidence of clots in the leg veins of women taking HRT. - Breast Disease
There may be increased risk of breast cancer in women who have taken HRT.
These risks may be far outweighed by the decreased risk of hip fractures, heart attacks, strokes and dementia discussed earlier.