Hormone therapy (HT) is a versatile treatment method for managing menopause symptoms, available in various forms such as patches and pills. A significant recent study has clarified many concerns, offering reassuring news for women considering this therapy.
Key Points to Remember:
– Safety in Use: Contrary to earlier apprehensions, new research indicates that using hormone therapy to alleviate menopause symptoms like hot flashes and night sweats does not increase the risk of mortality.
– Bone Health Benefits: Hormone therapy is effective in reducing bone loss and preventing fractures, providing a substantial benefit to postmenopausal women.
– Clarifying Misconceptions: The latest findings aim to ease the worries of women who have been confused by initial reports suggesting a link between hormone therapy and various health issues.
An expert in the field has clarified these points, ensuring women have accurate information to make informed decisions about hormone therapy. This comprehensive research should reassure women and healthcare providers about the safety and efficacy of hormone therapy in managing menopause symptoms.
If you’re unsure whether hormone therapy is a safe treatment for menopause symptoms like hot flashes and night sweats, your uncertainty is understandable. Even healthcare providers have expressed frustration over the mixed messages from the scientific community regarding the potential dangers of hormone therapy.
However, a new analysis from the Women’s Health Initiative, a two-decade-long study, adds to the growing body of evidence suggesting that hormone therapy is safe. Published on May 1 in JAMA, the analysis revealed that hormone therapy did not increase the risk of death from any cause in any age group when compared with a placebo.
While initial trial results from over 20 years ago indicated a heightened risk of heart attack, the long-term data demonstrated no statistically significant difference between those who took hormone therapy and those who did not. The risk of stroke among younger hormone users was relatively low, with fewer than one additional case per 1,000 women using estrogen-progestin therapy and no excess risk for those using estrogen alone.
The risk of breast cancer varied depending on the type of hormone therapy. Women who used estrogen alone (an option only for those who have had a hysterectomy) experienced a 20 percent reduction in breast cancer risk over the follow-up period. Conversely, the relative risk of breast cancer increased by about 20 percent with prolonged use of combination hormone therapy (estrogen and progestin), although the absolute risk remained low.
The analysis also showed that hormone therapy users had a 33 percent lower risk of fractures across all age groups compared to those taking a placebo. Hormone therapy is FDA-approved for reducing bone loss and preventing fractures.
Furthermore, the data indicated that the risk-benefit ratio for hormone therapy was more favorable for women aged 60 or younger, corroborating previous research findings.
Experts hope these latest findings will dispel any lingering doubts and provide a clearer understanding of the benefits and risks associated with hormone therapy. To delve deeper into this issue, Stephanie Faubion, MD, the director of the Center for Women’s Health at Mayo Clinic and the medical director of The Menopause Society (TMS), was asked to address and clarify any remaining confusion.
Understanding the Long-Term Findings from the Women’s Health Initiative
Dr. Stephanie Faubion emphasizes that hormone therapy remains the most effective treatment for menopause symptoms and is significantly underutilized. For women under 60 and within ten years of menopause onset, the benefits of hormone therapy for managing menopause symptoms and preventing bone loss typically outweigh the risks.
Evidence of Safety for Hormone Therapy in Treating Menopause Symptoms
Extensive research has demonstrated that hormone therapy effectively treats hot flashes, known medically as vasomotor symptoms of menopause. Even in the Women’s Health Initiative study, which did not specifically target vasomotor symptoms, the data indicated that the benefits of hormone therapy tend to outweigh the risks for women in their fifties, who are most likely to require treatment for these symptoms.
Concerns Over Nonhormonal Treatments
When women worry unnecessarily about hormone therapy, they may opt for nonhormonal treatments such as antidepressants, anticonvulsants, and dietary supplements. However, there is a lack of long-term data on the risks associated with these alternatives. For instance, antidepressants like SSRIs, commonly used for symptom management, have unknown long-term effects and can cause adverse effects. Similarly, gabapentin, used to prevent seizures and relieve nerve pain, can lead to substantial weight gain. Additionally, some women turn to cannabis, despite the absence of safety and efficacy data. There is also a prevalence of false advertising for supplements that claim unproven benefits and misleadingly suggest they are safer than FDA-approved hormones.
The Menopause Society’s Position on Hormone Therapy
The Menopause Society endorses hormone therapy for three main reasons: managing vasomotor symptoms (hot flashes and night sweats), treating genitourinary syndrome of menopause (which includes vaginal dryness, painful urination, or painful sex), and preventing bone loss to reduce fracture risk. Dr. Faubion advises that each woman should collaborate with her healthcare professional to determine the most effective formulation, dose, and route of administration. There is some observational evidence suggesting that transdermal administration (such as patches or creams) may be safer than oral routes. Furthermore, the variety of estrogens and progestogens, along with different delivery methods and doses, allows for individualized therapy based on a woman’s symptoms, medical history, and family history. Regular assessments are crucial, with patients typically returning once a year or sooner if symptoms change or new health issues arise. Hormone therapy is not meant to be a lifelong commitment nor is it advisable to discontinue it after a set period; decisions should be based on a woman’s ongoing need and health status.
The Impact of Hot Flashes and Night Sweats
Hot flashes and night sweats can significantly disrupt women’s lives, causing them to miss work, change jobs, or turn down career opportunities. These symptoms are not trivial; they affect women’s relationships and overall ability to function. Symptoms can persist for an average of seven to nine years, with one in three women experiencing them even longer. For those with moderate to severe symptoms, waiting for them to subside is often not a viable option.
Dr. Faubion’s Message to Women About Hormone Therapy
Dr. Faubion reassures women that hormone therapy is both safe and effective for managing hot flashes. She encourages women to seek clinicians certified in menopause management by the Menopause Society, which can be found at Menopause.org. There is no need to suffer through menopause symptoms when effective treatments are available.
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