Gynecology – Hormone Therapy

A popular treatment option for women undergoing menopause is hormone therapy. This includes treatment with hormones such as; estrogen, progesterone, or testosterone. Treatment may occur via pills, patches, injectables, or implantable pellets.

Perhaps, the biggest benefit to hormones is for the relief of menopausal symptoms such as; hot flashes, night sweats, vaginal dryness, trouble sleeping, forgetfulness, trouble concentrating, mood swings. Hormones work 90-95% of the time at controlling these symptoms. Other methods (anti-depressants, blood pressure medications, bellergal) work approximately 70% of the time, while placebo works 60% of the time. Hormones can also be used to control monthly flow.

Recently, there has been much hype in the public regarding risks of hormones. The Women’s Health Initiative (WHI) study found a slightly increased risk of breast cancer after four years in women taking Prempro©, a combination pill of estrogen and progesterone. This risk was only slight, however, and was not seen in women taking Premarin©, an estrogen only pill. Other studies in the past have shown this slightly increased risk of breast cancer, but studies have not shown an increased risk of breast cancer in women taking birth control pills. Also, some studies have shown that women taking hormones live longer than those who don’t. Studies looking specifically at breast cancer have shown that women on hormones at the time of diagnosis of breast cancer have an earlier stage of disease, live longer, and face a better prognosis than those women with breast cancer not on hormones at the time of diagnosis.

Another recent study (HERS – Heart and Estrogen/progesterone Replacement Study) has shown that women with heart disease being started on hormones have an increased risk of suffering an adverse cardiac event during the first year of use. For this reason, physicians will typically not start patients on hormones if they have heart disease.

To sum it all up – nothing is without risk. Everything we do in life involves risk and we, therefore, need to balance risks with the benefits to make the proper choices. Please schedule an appointment with your physician to see if hormones may be the right choice for you. She will help you balance those individual risks and benefits to aid in the making of an informed decision.