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Used to be, the only hot flashes about menopause were the bodily ones we women endured as we progressed through "the change of life."
Now the hottest flashes arrive via the news media as we learn more about the pros and cons of hormone replacement therapy (HRT). The most recent headline: Research has found that, far from protecting against memory loss, as we had thought, one popular form of combination (estrogen/progestin) HRT doubles the risk of dementia. (However the risk is still very small.)
Last year, a large government study of HRT's long-term safety was canceled in mid-project when it revealed that the risk of invasive breast cancer, heart disease, stroke, and blood clots increased among users of the estrogen/progestin combination.
So what do we do NOW? Do we have to resign ourselves to hot flashes, night sweats, weight gain, insomnia, lack of interest in sex, and the many other ills that can accompany "the change of life?"
The short answer—"It depends"—is not as unhelpful as it may seem. Because the longer answer is still, "Talk to your doctor. Find out what's best for you."
"A lot depends on why you are thinking of taking HRT and on your own family health history," says Stephen Rosenman, MD, chief of Gynecology at Bridgeport Hospital.
HRT for Heart? The current research does not support the use of HRT to reduce the risk of heart disease. So if you are taking HRT to protect your heart, ask your doctor about quitting.
HRT for Dementia? Evidence no longer supports the role of HRT in lowering the risk of diseases that affect the memory, possibly including Alzheimer's.
HRT for Osteoporosis? Evidence indicates that HRT can help to protect your bones against this disease that weakens the bones and leads to curvature of the spine and broken bones.
HRT for Symptoms of Menopause? If you are considering HRT solely to reduce the effects of menopause, you might find daily soy intake helpful: soymilk, roasted soy nuts, fresh soybeans (also called by their Japanese name: edamame), and tofu. If they are effective, that's great. But if they don't work, ask your doctor if you can still take HRT short-term (up to two years) to help you through menopause.
Balancing Risks and Benefits
A personal or family history of heart disease, stroke, or blood clots indicates that HRT is not a good idea for you.
A history of breast cancer might mean HRT is not for you. However, many women at risk of breast cancer can safely take HRT for a short period (up to two years) to carry them over the worst of the hot flashes and other menopause symptoms. If these symptoms are affecting your lifestyle, you might want to ask your doctor if HRT could be safe for you.
The No-Sweat Way to Go Off Hormones
If you've been taking hormones for a while, and your doctor now advises you to stop, you might want to think about tapering off rather than going cold turkey. If your doctor agrees, try half a pill a day, or one pill every other day, for a few months, to let your body get used to the lack of hormones. After all, that gradual decline in hormones is the way your body works naturally.
For a referral to an expert physician, call Bridgeport Hospital Services Referral, 24/7, English/Spanish, at 888-357-2396.
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