Hormone therapy, also known as estrogen replacement or menopausal hormone therapy, involves replacing the estrogen and/or progesterone that decline during menopause. Hormone replacement therapy is commonly prescribed to alleviate symptoms of menopause like vaginal dryness, hot flashes, and difficulty sleeping while reducing the risk of osteoporosis.
Despite being used for decades, there is a great deal of confusion surrounding hormone therapy. HRT became controversial after the Women’s Health Initiative study was halted early after researchers discovered a link between estrogen replacement with an increased risk of cancer and stroke. That study has since been questioned due to several flaws. Here are some important facts you should understand if you’re considering menopausal hormone therapy.
Hormone Replacement Lowers the Risk of Osteoporosis
Postmenopausal women are at a high risk of osteoporosis. This is because menopause eventually stops production of estrogen, which causes accelerated bone loss and osteoporosis. Bone loss of 1-5% may occur, beginning at the onset of menopause. Estrogen replacement therapy has been proven to boost bone mass, stop bone loss, and prevent fractures. The Women’s Health Initiative study found a 34% decrease in hip fractures among women on hormone therapy.
HRT Treats Menopause Symptoms
Hormone replacement can treat all symptoms of menopause, including hot flashes, night sweats, irritability, vaginal dryness and tenderness, and difficulty sleeping. For women who are only troubled by vaginal symptoms, a cream containing hormones may be used. Systemic hormone therapy treats all symptoms while reducing the risk of osteoporosis.
It May Help Prevent Alzheimer’s Disease
A recent study has found that hormone replacement may have another important benefit for women: it may help prevent Alzheimer’s and dementia. Women who carry the APOE-e4 gene show more active aging than women who do not. While 25-30% of the population carries at least one copy of the gene, 40% of Alzheimer’s patients are carriers. In the study, researchers found that women who were carriers were 6x more likely than non-carriers to show telomere shortening (cell aging) after they stopped hormone therapy. The study suggests that women who have this genetic risk factor for Alzheimer’s may benefit greatly from hormone therapy to reduce the risk of cellular aging and dementia.
Early Hormone Therapy May Reduce Heart Risk
One of the problems with the WHI study was it involved older women taking hormone therapy for the first time. A recent major study of 74,000 women in Sweden found that women who begin HRT at the start of menopause may actually lower their risk of heart disease and heart attack. It seems the timing of hormone therapy is very important when it comes to lowering risk.
New benefits of hormone therapy are discovered every year, although misconceptions about HRT persist. While hormone replacement is not right for every woman, it can reduce the risk of disease and bone loss in many cases.