Women, The Menopause And HRT
From about the age of 50, women will start go through menopause. This starts with the slowing down and subsequent stopping of ovulation and subsequent menstrual cycling, and along with a reduction in oestrogen and progesterone levels.
HRT really came to the publics attention in a book written 40 years ago called Feminine Forever, It was written by a British-born gynecologist called Dr. Robert A. Wilson. It was a national bestseller when it was published. Dr Wilson, who had moved to and practiced in New York, argued that “Many physicians simply refuse to recognize menopause for what it is – a serious, painful and often crippling condition.”
He proposed to give women Hormone replacement therapy from their mid to late forties treat the hot flushes, mood swings, difficulty sleeping and other symptoms that can accompany menopause. Dr Wilson was convinced that HRT was an almost miracle treatment that which would slow a woman’s aging process and apart from quelling the symptoms would also improve or gain back their sex lives.
He basically convinced everybody that this natural process was a disease and in doing so he managed to encourage Doctors and the drug industry to give HRT to healthy women over 50 as a lifelong drug.
This idea was very popular for many years, before proper controlled trials proved that HRT taken over extended periods was very bad, and had directly or indirectly caused many deaths in women, as well as other problems.
“a fair percentage of women will develop unpleasant symptoms”
WHAT IS HRT
Hormone replacement therapy (HRT) means replacing the naturally occurring usual hormones that deplete after normal or surgically induced menopause.
During menopause a fair percentage of women will develop unpleasant symptoms, the most common one is hot flushes especially during the peri-menopausal period (whilst they are entering into menopause). Other symptoms include broken sleep patterns (often made worse by the hot flushes) and also irrational thinking or behaviour. The majority of these symptoms are usually successfully treated with HRT. The male hormone testosterone, is sometimes used to improve sex drive in women which does sometimes drop during menopause.
Popular brand types of HRT include provera (progesterone) premarin (estrogen from a horse), and prempro (combination). .
HISTORY AND SIDE EFFECTS OF HRT
HRT is deemed as perfectly acceptable to use on a short term basis to treat the hot flushes and other symptoms of menopause, such as depression or insomnia.
For quite a while (until relatively recently) it had been prescribed to a vast number of woman. From its first prescription it was believed that HRT would reduce the risk of heart disease, strokes, and thinning bones (osteoporosis), and also that it would improve your memory, sexual drive and appetite.
It was not until a Health Study published in 1995 that showed a 32% increase in breast cancer with HRT that started to cause concern, despite this evidence the drug companies effectively ignored the facts and through extensive marketing racked up Billions of dollars worldwide in sales and prescriptions to women who were still convinced that these miracle tablets would make them better looking and keep them younger for longer.
The original argument and assurances that HRT reduced heart attacks was based on what are called observational studies. Women who took HRT were compared to those who didn’t, and were actually found to have fewer heart attacks. This actually turned out that these particular women were more concerned about their health and well being and also took regular exercise and kept to a strict diet . In these cases the HRT didn’t actually do anything.
IS HRT SAFE
The Women’s Health Initiative (WHI) carried out controlled trials which involved the random prescribing to over 16,000 post-menopausal women of either a sugar coated placebo or the HRT drugs oestrogen and progestin (equine oestrogen and medroxy-progesterone, or Prempro) The trial ran from 1993 to 1998.
The women who were prescribed Prempro recorded a rather shocking 24% increase in risk of heart attack. It was shown that the drugs increased the risk of breast cancer by 24%, and almost doubled the risk of blood clots.
There was about a 50% increase in ovarian cancer but the trial showed no real increase in uterine cancer. The drugs increased the risk of strokes by 31% but did reduce the risk of osteoporotic fracture.
Similar trials of oestrogen replacement have demonstrated increased rates of uterine and ovarian cancer. HRT raises the risk of blood clots that can lead to deadly pulmonary embolism (blood clots that travel to the lung and heart which will kill in approx 50% of cases.
HRT also increases the risk of gall bladder disease and of getting your gall bladder removed by 60%. For every one hundred women treated with HRT in WHI, one woman developed a serious adverse event directly related to the HRT.
OTHER SIDE EFFECTS OF HRT – Does it really work
Medical trials have showed that taking HRT accelerated the progression of thickening of the coronary arteries, and as a result increased the risk of dying of heart disease. A recent analysis showed a 29% increase in risk of stroke. Based on these findings, there is no role for HRT in disease prevention.
Other trials concluded that HRT had no effect either way on sexual appetite or moods, initially improvements in sleep cycles slipped back to their pre trial results. It was proven that Women who were given suger placebo pills recorded the same results as women who were given HRT.
HRT does have benefits, it will reduce the reduction of bone mineral density that occurs with normal aging, and therefore reduces the risk of osteoporotic fracture.Short term use will also reduce the hot flushes experienced by menopausal women. It will also improve the general mood in Women who have had surgically induced menopause (the removal of uterus and/or ovaries.
Natural Alternatives to HRT
More and more women just starting the menopause are now opting for natural treatments and/or supplements to help treat its symptoms, we hope that this site will help inform and guide you in your search for suitable treatments.