Hormone Replacement Hormone Replacement Therapy (HRT)Therapy (HRT)

Jenn Maddock and Lana Garrett

Health 3500

What is Menopause?

Cessation of menstruation as a result of the aging process of or surgical removal of the ovaries; change from fertility to infertility.

Physiological changes that take place within women between the ages of 30 to 60.

Hormone levels change in female body; practically the production of estrogen.

Perimenopause and menopause can last 10 plus years. Menopause itself begins 12 months after a woman’s final

period.

Symptoms of Perimenopause/Menopause

Cycles become irregular Erratic or heavy bleeding Decrease in sexual response Irritability/Mood Swings Fatigue Forgetfulness

Symptoms of Perimenopause/Menopause

Headache Hot flashes Night sweats Vaginal dryness Dry skin Bone loss Urinary incontinence

Hormone Replacement Therapy

Supplemental hormones: Estrogen, progesterone, and testosterone.

Estrogen and progesterone can be made from plants of from synthetic chemicals.

Delivery options: pills, patches, creams, inserted into vagina by means of creams, tablets or ring, placed under skin by implants or by injection; future: nasal spray.

Benefits of HRT

Maintains thickness and vascularity of vaginal and urethral tissue for comfort and lubrication during sexual interaction.

Reduces hot flashes and sleep disturbances from night sweats.

Protects against osteoporosis and resultant fractures, particularly of the hip.

Reduces risk of colon cancer

Media Reports of HRT

Media reports: Hazard Ratio- compares the difference between numbers of people in each treatment condition who experienced the health problem or benefit. Example: “The Scientists found a 29% increase in strokes, and a 26% increase in breast cancer.”

Absolute Risk- Compares the actual number of people who experience the problem or benefit.

Example: Women’s Health Initiative actual report was 8% increase in strokes, and 8% increase for breast cancer.

Estrogen Overload?

Estrogen in the Environment– Cow and Chicken Farms-Range Feed– Plastic– Pesticides

Diet Metabolism

Reducing the amount of Estrogen

Research looking at lower doses of HTR Balance of estrogen and progesterone

– Progesterone Cream

Stress Relief Liver Cleansing

Women’s Health Initiative2002

The study– 16,608 women– Women ages 50-79– Purpose was to identify risks and benefits of

long-term HRT use– Stopped prematurely because of findings

Women’s Health Initiative2002

Results– 26 percent increase of invasive breast cancer– 29 percent increased risk of death from

coronary heart disease– 41 percent increased risk of stroke– 200 percent increased risk of blood clots– Limitations to the study

Risks of HRT

Breast cancer– In 2003 there was 14,000 less cases of breast cancer

possibly due to the decrease in women taking HRT– If a woman is diagnosed with breast cancer while

taking HRT, she is advised to stop immediately. Endometrial cancer Cardiovascular disease Stroke Blood clots

Side Effects of HRT

Weight gain Bloating Breast tenderness Irregular bleeding Some do not take HRT for fear of cancer Some physicians recommend a

discontinuation of HRT

Alternative Therapies

One study indicated 68 percent of women have tried alternative therapies and 62 percent were satisfied with the results.

Diet and Exercise are the most common.

Alternative Therapies (Diet)

Soy isoflavones in soy products– Relieves a number of symptoms, including hot

flashes, night sweats, fatigue and vaginal dryness– Soy has also been shown to assist the body in

absorbing and retaining calcium, suppress bone loss, lower LDL cholesterol and decrease blood clotting

– Recommended daily amount is 25 grams of soy protein and 30-50 mg of isoflavones as a starting amount and could gradually increase to two to three times that amount

– Seen to reduce symptoms in 4 out of 10 women

Alternative Therapies (Diet)

Black Cohosh– Has been seen to reduce hot flashes– Potential for liver damage and shouldn’t take

more than 6 months

Calcium, magnesium and vitamins D & E– Magnesium promotes bone density– RDA is 600 mg, although most Americans

only consume 300 mg

Alternative Therapies

Exercise– A study in Sweden showed that out of 1,323 women,

15 percent sedentary women demonstrated hot flash symptoms compared to only five percent of the physically active subjects

– Weight bearing exercises and strength training strengthens bones and muscles, enhances self-esteem and creates a positive outlook, promotes sleep and increases levels of neurotransmitters in the brain

• Serotonin (calming effect), endorphins (pain killers), and dopamine (alertness and concentration).

Alternative Therapies

Smoking cessation– Reduces risk for pretty much everything!

Avoiding spicy foods for those who get heartburn– Can reduce severity and frequency of hot flashes

Limiting or eliminating caffeine– Promotes sleep

Relaxation methods– Helps with mood swings/irritability

Alternative Therapies

Acupuncture Reflexology Controlling weight and avoiding weight

gain Preparing for hot weather by wearing

layers of clothing and bringing a small fan

Conclusion

Controversial subject Limited extensive scientific research Limitations on the studies conducted HRT or not?

– History of breast cancer– Presence of other risk factors

THE END

Any Questions?