Menopause Part 2 – HRT (Hormone Replacement Therapy)

Please see Menopause Part 1 to learn more about menopause and about the dietary and lifestyle changes which can help to manage menopausal symptoms.

HRT patch. Image by James Heilman, MD (Own work)

Combined HRT
In certain women with disabling menopausal symptoms, Hormone Replacement Therapy (HRT) can play an important role in reducing symptoms and deferring loss of bone density.

More data is becoming available about the risks and benefits of HRT. Below we explore the latest information about Combined HRT (oestrogen + progesterone):

Breast Cancer
• For women aged 50-59 who use Combined HRT, there is no increase in breast cancer risk for short term use of less than three years.
• For women of the same age, using Combined HRT for five years probably leads to three extra cases of breast cancer in every 1000 women
• There is much less risk for women using Combined HRT before the age of 50 in the case of premature menopause

Ovarian Cancer
The UK Million Woman Study concluded that HRT taken over five years resulted in one extra case of ovarian cancer in roughly 2,500 HRT users. Other reputable studies have shown no significant increases.

Cardiovascular Risks
During menopause, a woman loses some of the previously protective effects of oestrogen on her heart. HRT could reduce the chance of heart disease in some higher risk cases. This decision needs to be balanced against a very small increased risk of DVTs (blood clots) associated with the use of HRT.

Looking at the entire picture, the risks of serious complications are relatively low in appropriately screened women under the age of 60 who are taking the lowest dose of Combined HRT required to relieve their symptoms. Hence, Combined HRT can be beneficial in these women as long as individual risk factors are carefully considered and the lowest effective dose is used.

There are many factors involved in deciding whether Combined HRT is an appropriate choice for an individual woman. In some cases, other types of HRT or other treatments may be safer. It is always best to seek advice from your doctor if you are considering HRT.

At The Walcote Practice, our doctors are highly experienced in helping patients to address the symptoms of menopause. They are also able to explore the option of HRT in detail. To book an appointment, please call 01962 828715.