Should a woman have hormone replacement therapy?

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By Dr. Victor Dumaguing

To Your Health

Friday, November 23, 2012


FIRST and foremost, this author would like to apologize to our dear readers and friends for the delay of the appearance of this article, which for all the high-tech advantages of computers and gadgets, got lost in transit. At any rate, it is our fervent hope that the delay has not at all, diminished the enthusiasm and interest of our beloved women of menopausal age, including their anxious husbands.

Our health columnist-colleague Ms. Sara T. Poumerol says that doctors prescribe HRT for two major reasons; relief of menopausal complaints, in which treatment is given for two to three years and then tapered off; and/or protection against osteoporosis and other long term ailments. Women have a variety of treatments from which to choose.

Women who have had hysterectomy (removal of the uterus) together with her two ovaries are often given estrogen therapy. Otherwise, most women use a combination of two hormones (estrogen and progesterone) to counter the negative effect of estrogen on the uterus. Relief of urogental signs and symptoms is also available in estrogen vaginal suppositories, cream and the so-called vaginal ring.

Today, doctors and psychologists as well as marriage counselors understand the more complex nature of the maintenance of libido (sexual urge and desire) of women, even in their menopausal stage. Female sexual urges, as well as the male libido is activated by male sex hormones or androgens. Women naturally produce androgens during their 20s and 30s - more than their output of estrogens. A new formulation that combines male and female hormones (estrogen-androgen combination) replaces the lost androgens in menopausal women providing a big boost to their sexual drive and a significant improvement in their mood and energy level, thus improving their quality of life. Also, as compared to estrogen alone, the estrogen-androgen combination may better protect against ospteoporosis because androgens are important for maintaining bone density.

Some researchers have shown that when taken for over five years, HRT might boost a woman's chance of getting breast cancer by 30 to 40%. The data so far are not compelling nor consistent for a strong link between HRT and breast cancer. At that time, the medical world recommended against prescribing conventional HRT for women at high risk for breast cancer (if she has a mother, sister or daughter with premenopausal breast cancer.

Nowadays, the thinking and the attitude has changed. Many medical societies have discovered that based on experience and research, the benefits of HRT greatly outweighed the risks, unless the woman has two family relatives with breast cancer. Besides, some researchers believe that estrogen may actually benefit women who have already survived breast cancer.

As a personal rejoinder, this author  strongly advise every woman, of menopuasal vintage, to consult their family physician and make informed co decisions before their consent is given to undergo hormone replacement therapy.

Published in the Sun.Star Baguio newspaper on November 24, 2012.

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