 by Robin Parks, MS What is hormone replacement therapy? Estrogen replacement therapy (ERT) refers to the daily use of estrogen to increase a woman's hormones to premenopausal levels. Women with a uterus who take estrogen also need the hormone progestin to prevent the estrogen from affecting the uterine lining (endometrium), which can lead to endometrial cancer. The combination of estrogen and progestin is called hormone replacement therapy (HRT). Women with a uterus take HRT. Women who have had a hysterectomy to remove the uterus take ERT. The U.S. Food and Drug Administration (FDA) has updated its HRT recommendations and now only approves estrogen-progestin HRT for: * Short-term treatment of perimenopausal symptoms. Women who do decide that HRT benefits outweigh their risks are advised to use the lowest effective dose for as short a time as possible, not exceeding 3 or 4 years. * Osteoporosis prevention and treatment, in select, severe cases. Most experts recommend that HRT only be considered for women with significant risk of osteoporosis that outweighs their risks from taking HRT.10 Women are now encouraged to consider all possible osteoporosis treatments and to compare their risks and benefits.11 For more information, see the topic Osteoporosis. The FDA is reviewing its ERT recommendations, based on March 2004 stroke risk information from the Women's Health Initiative ERT study.12 Other low-dose ERT research is currently in progress. What are the benefits of taking estrogen? When taken as ERT or HRT, estrogen: 2, 1 * Helps prevent osteoporosis after menopause by slowing bone loss and promoting some increase in bone density.1 * Reduces hot flashes and sleep problems in most, but not all, women.1 * Maintains the lining of the vagina, reducing irritation. * Maintains skin collagen levels, which decline as estrogen levels decline. Collagen is responsible for the stretch in skin and muscle. * Increases the amount of HDL (“good”) cholesterol and decreases the amount of LDL (“bad”) cholesterol in the blood. * Reduces the risk of dental problems, such as tooth loss and gum disease. * May reduce the risk of colon cancer.2 What are the risks of hormone replacement therapy? HRT increases the risks of breast cancer, ovarian cancer, blood clots, heart disease, stroke, and dementia. Estrogen alone (ERT) is also linked to increased stroke, ovarian cancer, dementia, and possible breast cancer risk.13, 5, 14 No particular form or dosage of ERT or HRT has been proved safer than another.15 Among the women using HRT in the recent Women's Health Initiative trials, most did not develop major health problems. But after the first 1 to 4 years of using HRT, a small yet significant number of women did develop signs of cancer, blood clots, heart disease, stroke, and dementia.2, 3, 4 * Within the first 2 years, HRT use slightly increased the risk of blood clots in the lungs (pulmonary embolism) and legs (deep vein thrombosis) in all healthy postmenopausal women regardless of risk factors.16 * During the second year, HRT use began to slightly increase heart attack and stroke risk in all healthy postmenopausal women, regardless of risk factors. Early signs of heart disease first became apparent during the first year of use.16, 6 Heart disease risk does not increase for women in the first 10 years after menopause.17, 7, 8 * After 1 year, HRT use increased the number of abnormal mammograms by approximately 4% each year. Daily estrogen-progestin increased breast density compared with estrogen alone or placebo. Although the abnormal mammograms required additional medical evaluation, they were not linked to an early increase in breast cancer. Studies are ongoing to learn more about breast density change from HRT.3 * After 4 years of use, HRT-related breast cancers first became apparent. The number of HRT-related breast cancers increased with each additional year of HRT use. Women taking HRT generally had larger, more advanced tumors than women who developed breast cancer while taking a placebo treatment.2 (But some of these cancers may respond more favorably to treatment.)18 Home page Sitemap Beauty tips Beauty glossary Young tips Skin care tips Detoxification Aging Health tips All about Green tea All about Weight loss Sleeping tips Tag: HRT, menopause, perimenopause, women's health, hormone replacement therapy, phytoestrogen, pueraria mirifica phytoestrogen herb, white kwao krua | 
