Hormone replacement therapy (HRT) involves taking estrogen, progesterone, or both to supplement declining levels during perimenopause and postmenopause. The goal of HRT is to relieve symptoms like hot flashes, night sweats, vaginal dryness, and mood changes.
However, research shows there are risks associated with HRT:
- Multiple studies link estrogen-only HRT to an increased risk of uterine cancer if you haven't had a hysterectomy. The risk seems to go back down after stopping the estrogen.
- Combination estrogen and progestin HRT has been associated with a small increased risk of breast cancer. This risk seems to go back down after stopping combination HRT.
- Both estrogen-only and combination HRT increase the risk of blood clots, stroke, and heart attack in some women, especially if started in women over 60.
The longer you take HRT, the greater these risks seem to become over time. However, the risks associated with HRT seem to be small. The National Cancer Institute notes
hormone therapy for up to 5 years does not appear to increase breast cancer risk in women with no pre-existing risk factors.
Current recommendations are:
- Use the lowest dose needed to manage menopause symptoms
- Take for the shortest time possible
- For estrogen and progestin combination therapy, it is recommended to use for 1 year or less
- Be monitored regularly by your healthcare provider
- Report any unusual vaginal bleeding which can be a sign of uterine cancer
- Get regular mammograms to check for breast cancer
Your personal risks and benefits should be weighed carefully. The small increased risk of taking HRT for a limited time may be worth it for some women to relieve disabling menopause symptoms. Treatment can be stopped if intolerable side effects occur. While desired effects reverse when stopping, it can take time for associated risks to decrease back to baseline.
There are alternative therapies that may provide relief without the same cancer risks associated with HRT:
- Prescription medications like low-dose antidepressants
- Vaginal lubricants/moisturizers and local vaginal estrogen preparations
- Lifestyle changes like avoiding triggers, mindfulness techniques, acupuncture
If your symptoms persist despite these options, HRT may still be reasonable for short-term use with guidance from your doctor. Get screened for risk factors like dense breasts or family history of cancers. Choosebioidentical hormones over synthetic when possible.
Bioidenticals are identical in molecular structure to the hormones naturally occurring in the human body, while synthetics are not. Here at
Vitality Hormone Center, our practitioners specialize in custom-compounded
bioidentical hormone therapy to provide the right dose and balance for your unique needs.
In summary, there are increased health risks including cancer associated with long-term use of systemic hormone replacement therapy. However, short-term low-dose use under medical supervision seems reasonably safe for many women struggling with severe menopause symptoms not relieved by other therapies. Get screened for your personal risks, try alternative options first, and weigh the benefits versus potential harms in your individual situation. If HRT is recommended in your case, choosing custom-compounded bioidentical hormones specifically tailored to your needs can help minimize risks. Reach out to our knowledgeable clinicians at Vitality Hormone Center whenever you have questions about what treatment options are right for you!
