HRT if used
properly and under expert care have the potential to offer multisystem benefits
at relatively low cost. But, sadly the acceptance of HRT is quite low in
society because of risk of breast cancer and is frequently discontinued because
of breakthrough bleeding.
The
acceptance further dropped after the results of Women's Health Initiative study
(WHI) in 2002 found that it actually increased a woman's risk of heart disease,
stroke, dementia and breast cancer.
Within
months a 50% drop was noticed in women using HRT.
But a final
comprehensive report published in JAMA and took a deeper look at the WHI study
and the results were broken down according to age and number of years elapsed
since menopause.
The key
findings were HRT is appropriate for younger women who are in early menopause because
the Quality of life benefit derived will be much more as compared to the adverse
effects. In older women who are 60+ the risks are entirely different and outweigh
the harm.
The dilemma
has since continued about initializing or extending HRT in women who are 60+
years. Some women still want to continue using hormones because of the ‘feel
good factor’ or because the menopausal symptoms of hot flashes and urogenital
syndrome of menopause still continue bothering her.
The North
American Menopause Society (NAMS) thinks that women should be evaluated
according to circumstances and risk/benefit ratio. They should use the lowest
possible dose under strict monitoring.
This latest
video, Extended Hormone Therapy Use, Dr. Shapiro interviews Dr. Cynthia
Stuenkel, Past President of NAMS, an internist, endocrinologist, and
reproductive endocrinologist at the University of California, San Diego. Dr.
Stuenkel discusses the safety and risk for hormone therapy use in women 65
years of age and older.
Dr Stuenkel
discusses risk and benefits of hormone therapy for women 65+
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