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The Risks, Benefits, and Side Effects Associated with Hormone Therapy

with Dr. Lila Nachtigall

It is an interesting issue when discussing the risks, benefits and side effects of hormone therapy, meaning estrogen or estrogen progesterone therapy, because it really is so variable depending on the individual patient or women.

What is the Women's Health Initiative?

The Women’s Health Initiative was a very large and significant study that was conducted and consisted of three clinical trials to address major health issues causing morbidity and mortality in postmenopausal women. These clinical trials were designed to test the effects of postmenopausal hormone therapy, diet modification, and calcium and vitamin D supplements on heart disease, fractures, and breast and colorectal cancer.

Specifically in 2002, the trial regarding postmenopausal hormone therapy that was conducted concluded that there were too many side effects compared to a placebo in women that were given hormones--but the truth was that only 25 women per 10,000 women had any significant side effect.

What needs to be realized and taken into consideration is that 925,000 women that were studied did not have any side effects. That’s definitely a much nicer way to look at it. In other words, the severity of those side effects are rare and  not ideal to be symptomatic. If there is a side effect or complication it is very important to be taken off that certain medication or therapy.

What are risks associated with hormone therapy?

Furthermore, there are certain risks known to exist where treatment can enhance in a negative way. For example, that could be a clotting risk. A blood clot is a gel-like clump of blood that causes bleeding to stop. This is ideal in response to injuries when you don’t want to bleed but can be more critical if a clot is present without good reason in more serious locations such as your lungs, brain, legs, etc.

If a patient is prone to blood clots, then hormone therapy wouldn’t be administered. Postmenopausal hormone therapy increases the chances of developing blood clots by two to four times. Women generally have an increased risk of clots such as vein clots or arterial clots by nature. Knowing this and that estrogen and progesterone increases the risk of clotting still doesn’t necessarily mean you will encounter that risk. A healthy woman with no history of clotting is much less likely to experience that risk than a woman who has a history of blood clots.

Each woman and each patient must be individualized as other factors such as the patient's age, how many years from menopause she is, how long she has been in menopause and also all previous health history combined are very crucial information needed. Therefore, it is imperative to be checked out by a physician as soon as symptoms of menopause appear, even more so if postmenopausal hormone therapy is under consideration.

The benefits of administering hormone therapy is to mitigate the discomfort level some women may experience when it comes to their symptoms.

If you're experiencing menopausal symptoms that cause you discomfort, consult with your physician today to see if hormone therapy is an appropriate option for your condition.