Hrt Does Not Cause Weight Gain
Weight gain at the menopause is related to age and lifestyle factors. An increase in body fat, especially around the abdomen, can occur during menopause because of hormonal changes, although exactly why this happens is not clear. Normal age-related decrease in muscle tissue, and a decrease in exercise levels, can also contribute to weight gain.
Most studies do not show a link between weight gain and HRT use. If a woman is prone to weight gain during her middle years, she will put on weight whether or not she uses HRT.
Some women may experience symptoms at the start of treatment, including bloating, fluid retention and breast fullness, which may be misinterpreted as weight gain. These symptoms usually disappear once the therapy doses are changed to suit the individual.
Choosing The Right Hrt For You
It is important to find the correct HRT to help your symptoms.
A low dose of HRT hormones is usually prescribed to begin with. If you need to, you can increase your dose at a later stage.
Once you’ve started HRT, it’s best to take it for a few months to see if it works well for you. If not, you can try a different type or increase the dose. It’s really important that you talk to your GP if you have any problems with HRT.
Should You Quit If So When
There is no set time a woman should be on HRT. “We ask a woman to go off hormones at 5 years,” says Anne W. Chang, MD. “We talk about the reasons why she should go off. But it’s a shared decision.”
“Being on hormones longer doesn’t raise your risk for blood clots, but age does,” Chang says.
Isaac Schiff, MD, goes over the pros and cons of quitting of hormone therapy with his patients every year. He says he puts the cons, like breast cancer risk, in perspective.
“If you aren’t on hormones, your risk of breast cancer is 3 out of 1,200 per year,” Schiff says. “If you’re on hormones, it’s 4 out of 1,200.” Some women are comfortable staying on hormones with that risk. “It’s a very individual decision,” he says.
Women who have had their uterus removed are often given estrogen only. They aren’t more likely to get breast cancer, so many decide to stay on hormones longer.
You May Like: Tubal Ligation Early Menopause
What Is Known About Hormone Therapy And The Risk Of Breast Cancer
Taking combined hormone therapy can increase your risk of developing breast cancer. Here are some important findings:
- Taking combination hormone therapy showed a rare increase of absolute risk of less than one additional case of breast cancer per 1000 person years of use.
- There was a nonsignificant reduction in breast cancer seen in women with hysterectomies on estrogen only therapy.
- If youve been diagnosed with breast cancer you should not take systemic hormone therapy.
Hormone Therapy: For Whom How Long
When Is Menopausal Hormone Therapy Appropriate? Expert Panel Weighs In
Endocrinologist Bruce Ettinger, MD, and colleagues boldly go where none has gone before. Their mission: to determine, specifically, what is an “acceptable” use of hormone therapy, and what is “unacceptable.”
“We felt that guidance we were getting from major medical societies was too vague — it leaves too much unsaid, and there is not enough information to help people make decisions,” Ettinger tells WebMD. “Even though our panel never gets to perfect agreement, we can say, “This is mainstream activity, and this is not.”
Ettinger, a Kaiser Permanente researcher and a clinical professor of medicine at the University of California, San Francisco, and colleagues report their finding in the current issue of the journal Menopause.
You May Like: Sweet Potato Menopause
What Questions Remain In This Area Of Research
The WHI trials were landmark studies that have transformed our understanding of the health effects of MHT. Its important to note that women who were enrolled in the WHI trials were, on average, 63 years old, although about 5,000 of them were under age 60, so the results of the study may also apply to younger women. In addition, the WHI trials tested single-dose strengths of one estrogen-only medication and one estrogen-plus-progestin medication .
Follow-up studies have expanded and refined the original findings of these two trials. But many questions remain to be answered:
- Are different forms of hormones, lower doses, different hormones, or different methods of administration safer or more effective than those tested in the WHI trials?
- Are the risks and benefits of MHT different for younger women than for those studied in the WHI trials?
- Is there an optimal age at which to initiate MHT or an optimal duration of therapy that maximizes benefits and minimizes risks?
How Long Can You Take Hormone Replacement Safely
Hormone replacement therapy is oftentimes an effective solution for men and women struggling with symptoms of hormone imbalance related to aging or certain conditions and diseases. Hormone therapy is one of the most effective treatment options for hormone imbalance when administered under the care and guidance of a highly-trained medical practitioner.
The safety and efficacy of hormone replacement therapy is largely dependent on the medical team you choose to partner with for your treatment plan. There is no one-size-fits-all planthe length of time that you can safely supplement hormones varies by patient and the condition being treated. Discover how to make the best choice for your health.
What Is Hormone Replacement Therapy ?
Hormone replacement therapy is supplementation of exogenous hormones to treat hormonal imbalance. Therapy is available in a variety of forms and delivery methods. Perimenopause and menopausal symptoms in women are among the most commonly diagnosed conditions of hormone imbalance that are frequently treated with estrogen and progesterone therapyexamples of hormone replacement therapy. Andropause, or low testosterone in men, is another frequently diagnosed condition of hormone imbalance that is treated with testosterone therapy, another example of HRT. However, thyroid disorders and adrenal fatigue, among other conditions may also be treated with hormone replacement therapy.
What is Bioidentical Hormone Replacement Therapy ?
Read Also: Menopause Dizziness Treatment
Does Hrt Increase The Risk Of Womb Cancer
The risk of womb cancer depends on the type of HRT.
Oestrogen-only HRT increases the risk of womb cancer. The longer this type of HRT is used, the bigger the risk. Thats why oestrogen-only HRT is usually only offered to those who have had their womb removed as they have no risk of womb cancer to begin with.
Combined HRT can reduce womb cancer risk. But combined treatment causes the biggest increase in breast cancer risk. So, its important to talk to your doctor about the balance of possible benefits and risks for you.
Similar to oestrogen-only HRT, tibolone also increases the risk of womb cancer.
Putting The Risks And Benefits Of Hrt In Perspective
If you’re just glancing at list above, some of the risks of HRT might seem to overwhelm the benefits. Could a reduction in vaginal dryness possibly be worth an increased risk of cancer?
But look at the details. The risks of HRT — while real — are quite small for an individual person. For example, the 2002 Women’s Health Initiative study found that ERT increased the risk of strokes by 39%. That sounds frighteningly high. But the actual number of people affected is very small. Out of 10,000 women who are not taking ERT, 32 have strokes each year. Out of 10,000 who are taking ERT, 44 have strokes each year. That’s an increase of just 12 people out of 10,000.
On the other hand, when it comes to controlling the symptoms of surgical menopause, a huge number of women feel the benefits. One out of four menopausal women has severe hot flashes. Treatment with hormone therapy cuts down the number of hot flashes per week by 75%. So if a woman had 24 hot flashes per week, HRT would drop that number to six. That could make a big difference in the quality of their day-to-day life.
Ways To Quit Hormone Replacement Therapy
There is no best way to stop HRT. “If you’re on a low dose, you may be able to go cold turkey,” Chang says. But in general, she and Schiff prefer that women taper off hormones slowly. You can do this by:
- Lowering the dosage
- Taking fewer pills per week
Work with your doctor to find the best plan for you.
Concerns Over The Safety Of Hrt A History
HRT was first available in the 1940s but became more widely used in the 1960s, creating a revolution in the management of the menopause. HRT was prescribed commonly to menopausal women for the relief of their symptoms such as hot flushes, night sweats, sleep disturbances, psychological and genito-urinary problems urinary frequency and vaginal dryness and for the prevention of osteoporosis.
In the 1990s two of the largest studies of HRT users were undertaken, one clinical randomised trial in the USA and one observational questionnaire study in the UK . The published results of these two studies during 2002 and 2003 raised concerns regarding the safety of HRT. These safety concerns revolved around two main issues: 1) that the extended use of HRT may increase the risk of breast cancer and 2) that the use of HRT may increase the risk of heart disease.
The results of the studies received wide publicity, creating panic amongst some users and new guidance for doctors on prescribing.
After the results were published, the UK regulatory authorities issued an urgent safety restriction about HRT, recommending that doctors should prescribe the lowest effective dose for symptom relief, should use it only as a second line treatment for the prevention of osteoporosis, and advised against its use in asymptomatic postmenopausal women.
Also Check: Does Menopause Cause Dizzy Spells
Oestrogen Combined With A Serm
SERMS are a newer treatment option for menopause. They have anti-oestrogen or oestrogen-like effects that vary in different parts of the body.
A tablet containing conjugate equine oestrogen combined with the SERM bazedoxifene improves menopausal symptoms, bone density and reduces breast density. Bazedoxifene, like progestogen, reduces the risk of cancer of the lining of the uterus in women who have not had a hysterectomy.
- SERMs can be combined with oestrogen to improve symptoms, improve bone density and reduce the risk of uterine cancer.
Where Does Evidence About The Health Effects Of Mht Come From
The most comprehensive evidence about the health effects of MHT comes from two randomized clinical trials that were sponsored by the National Institutes of Health as part of the Womens Health Initiative :
- The WHIEstrogen-plus-Progestin Study, in which women with a uterus were randomly assigned to receive either a hormone pill containing both estrogen and progestin or a placebo. The median duration of treatment was 5.6 years.
- The WHI Estrogen-Alone Study, in which women without a uterus were randomly assigned to receive either a hormone pill containing estrogen alone or a placebo. The median duration of treatment was 7.2 years.
More than 27,000 healthy women who were 50 to 79 years of age at the time of enrollment took part in the WHI hormone therapy trials. The goals of these trials were to see if MHT prevents heart disease and bone fractures in postmenopausal women and to determine if MHT affects risks of breast cancer and, for women with a uterus, endometrial cancer. Both trials were stopped early , when it was determined that both types of therapy were associated with specific health risks, but long-term follow up of the participants continues to provide new information about the health effects of MHT.
Recommended Reading: Can You Have Menstrual Cramps During Menopause
Waiting 5 Years To Start Hormone Replacement Therapy Offers Less Risk
Many studies have shown a link between increased breast cancer risk and hormone replacement therapy to treat bothersome menopausal symptoms. While the results of all the studies aren’t exactly the same, there is good evidence that:
- HRT increases the risk of being diagnosed with invasive breast cancer
- breast cancer risk increases within the first several years of HRT use risk appears to increase the longer a woman uses HRT
- combination HRT increases breast cancer risk more than estrogen-only HRT
- high-dose HRT increases risk more than low-dose HRT
A study found that breast cancer risk was higher in women who used HRT during the first 5 years after menopause started compared to women who waited more than 5 years to start HRT.
This research is part of the very large Million Women Study. The Million Women Study included nearly 1.3 million women in the United Kingdom and was designed to identify links between diet and lifestyle factors and health problems such as cancer. The women, who were about 57 years old, started the study between 1996 and 2001.
More than half of the women had used some form of HRT at some time in their lives and 35% were using HRT when the researchers did the analysis. The researchers recorded 15,759 breast cancers diagnosed in the 1.3 million women.
More than 60% of the breast cancers were diagnosed in women who had used HRT at some point 45% of the breast cancers were diagnosed in women using HRT when the cancer was diagnosed.
How Long Can I Take Hrt
Doctors are now initially prescribing HRT in the lowest dose possible, making modifications as necessary until effectiveness is achieved.
All potential risks must be taken into consideration based on thorough disclosure of your symptoms, medical history, family history, and lifestyle. This is vital to insure the best outcome for your individual needs, and whether the benefits outweigh the risks. At one time, it was thought that taking HRT for five years or less posed no danger, but recent findings proved that, depending on the individual, there can be problems even during this short time span. Other women may not be negatively affected at all.
Today, women using HRT are being prescribed lower doses than before. There are also different methods available besides the past standard oral prescriptions. Vigilant and regular monitoring can alert us to any issues that may arise so that you can receive immediate intervention.
Read Also: Early Menopause After Tubal Ligation
How To Get Started On Hrt
Speak to your local GP practice if you’re interested in starting HRT.
You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. However, a blood test to measure your hormone levels may be carried out if you’re aged 40 to 45. Blood tests may also be carried out to help diagnose suspected premature menopause if youre under 40 and have menopausal symptoms.
Your GP can explain the different types of HRT available and help you choose one that’s suitable for you.
What Are The Other Benefits Of Taking Hrt
Taking HRT can prevent and reverse the bone loss that occurs, even for those women who take low doses of HRT. This means that taking HRT reduces your risk of having a fracture due to osteoporosis. This benefit is maintained during treatment but does reduce when you stop taking HRT. However, there is some evidence that this reduction in risk of fracture persists for a length of time even when you stop taking HRT.
Some studies have shown a reduced risk of Alzheimers disease and other types of dementia in women who take HRT. However, other studies have not shown this, so more work needs to be done in this area. In addition, some studies have also shown a reduction in risk of bowel cancer in women who take HRT. However, the evidence for this is still not completely clear.
Don’t Miss: Menopause And Dizzy Spells
Added Benefits Of Hrt
HRT reduces the risk of various chronic conditions that can affect postmenopausal women, including:
- diabetes taking HRT around the time of menopause reduces a womans risk of developing diabetes
- osteoporosis HRT prevents further bone density loss, preserving bone integrity and reducing the risk of fractures, but it is not usually recommended as the first choice of treatment for osteoporosis, except in younger postmenopausal women
- bowel cancer HRT slightly reduces the risk of colorectal cancer
- cardiovascular disease HRT has been shown to reduce cardiovascular disease markers when used around the time of menopause.
How Quickly Does Hrt Make A Difference
Many women find that all their symptoms of the menopause improve within a few months of taking HRT. They often notice that their sleep improves, their mood improves and their concentration recovers. They also often notice that their energy is much greater than it was before they started taking HRT.
HRT works really well to improve menopausal symptoms. In addition, it can help to reduce the health risks associated with the menopause.
HRT usually works to stop hot flushes and night sweats within a few weeks. In addition, HRT will reverse many of the changes around your vagina and vulva usually within one to three months. However, it can take up to a year of treatment in some cases.
This means that HRT can improve symptoms of vaginal dryness, improve discomfort during sexual intercourse, help to reduce recurrent urine infections and also improve any increased frequency of passing urine.
You may find that any aches or pains in your joints improve and also that the texture of your hair and skin improve when taking HRT.
Don’t Miss: Menopause Apron Belly
Side Effects Of Female Hormone Cream
Despite all the efforts of specialists in the field of pharmacology, not a single drug has yet been created that could not provoke the occurrence of side effects. This is a reality that should be taken calmly and without undue panic. Further, not all negative reactions that are indicated in the instructions for medications will occur when taking it.
The development of negative reactions in a person to a particular preparation individually and largely depends on compliance with the manufacturers recommendations regarding the correct intake of the medicine. As for HRT gel, therapy with this agent can hypothetically lead to the following undesirable phenomena:
- allergic skin rash and facial swelling
- the occurrence of thickening in the mammary glands
- blurred vision
- increased hunger or thirst.