Hormone Replacement Therapy (HRT)

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REVIVAMED PLASTIC SURGERY / INTEGRATIVE MEDICINE / HORMONE REPLACEMENT THERAPY (HRT)

Hormone Replacement Therapy Risks & Benefits

Women wishing to start HRT should carefully discuss the benefits and risks of treatment with their doctor to see what is right for them and taking into account their age, medical history, risk factors including family history of Breast, Ovarian or Uterine cancer and personal preferences.

For the majority of women who use HRT for the short-term treatment of symptoms of the menopause, the benefits of treatment should always outweigh the risks. Every patient has to be carefully evaluated and their individual risks needs to be assessed. No HRT is without risks, any form of estrogen and progesterone be it plant based or synthetic can potentially increase risks of breast cancer, ovarian cancer and endometrial cancer in certain individuals. Therefore the use of HRT is not recommended for everyone and we have to always carefully individualize its use.

The lowest effective HRT dose should be taken, with duration of use depending on the clinical reasons for use. Women on HRT should be re-assessed by their doctor every 6 months. Use of HRT beyond the age 60 is not recommended. Annual mammography is often a requirement to ensure safety and wellbeing of the patient.

Bio-Identical Hormones

Bio-identical hormones are hormone preparations which are identical molecules to those produced by the body. However, in practice the term is used for preparations made by compounding chemists which are claimed to be safer than “traditional” hormones used in hormone replacement therapy (HRT). In fact, some traditional HRT preparations are actually “bio-identical”, using estradiol 17-beta which is the natural human estrogen, or using micronized progesterone capsules which is identical to the natural human progesterone.
It should be obvious that any product which is a “bio-identical” HRT will carry the same benefits and risks as the HRT products produced by pharmaceutical companies and properly licensed for use, and there is absolutely no evidence that the bio-identical hormones are any safer than those used in traditional HRT. Indeed, they may be less safe – their production is not monitored by government drug regulatory authorities and thus their dosage may be inaccurate or inconsistent, their purity is certainly not guaranteed, and their safety is not tested as it is with approved HRT formulations.

For a detailed look at potential risks please look at the Women’s Health Initiative Study (WHI)

If women start HRT after menopause, the risk may outweigh benefits but again every patient has to be fully assessed regardless of age. There is only limited data for continued usage beyond the age of 60. It is not usually appropriate for women over 60 to be starting HRT, as the WHI study shows, the risks for cardiovascular events and hormone related cancers including Breast, Ovarian and Uterine cancer are increased.

Many women seek advice on the effects of HRT on sexual activity and desire. While there is no definitive answer, case studies indicate that the estrogen and testosterone in HRT can help maintain or return sex drive. Low dose estrogen vaginal preparations can help other menopausal symptoms such as vaginal

dryness and pain with intercourse. If vaginal symptoms are the only problem, then the use of local vaginal estrogen or even DHEA at very small doses may be preferable. When HRT is taken for the correct reasons, i.e. to alleviate the symptoms of the menopause, it has a role in the prevention of osteoporosis but long term use is often required and that use needs to be looked at carefully to ensure the risks of Breast Cancer, Ovarian Cancer, Endometrial Cancer is not increased with this long term exposure to HRT beyond the menopausal years.

Your safety and wellbeing is of outmost importance.

Revivamed prides itself in evaluating each patient carefully in a scientific way while taking into accounts many personal, genetic and environmental factor that can collectively affect your health.

Please talk to your doctor before starting any form of HRT to make sure the benefits outweigh the risks.