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Category Archives: Hormone Replacement Therapy
Hormone replacement therapy, also referred to as HRT, is used to relieve menopause symptoms, especially hot flashes and osteoporosis. A woman on hormone therapy usually takes both estrogen and progestin. Women who have had a hysterectomy can take estrogen alone. Estrogen relieves hot flashes and prevents osteoporosis. However, estrogen alone can increase your risk of developing uterine cancer.
Many studies have looked at the association between hormone replacement therapy and breast cancer. The best evidence for the benefits and risks of hormone replacement therapy come from the Women's Health Initiative (WHI), a large study involving more than 16,000 healthy women. The results published in July 2002 showed the risks of combined HRT with estrogen plus progestin outweigh the benefits. These risks included an increase in breast cancer, heart disease, stroke, and blood clots.
Under the Affordable Care Act, many health insurance plans will provide free womens preventive services, including mammograms, birth control and well-woman visits. Learn more.
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Not only does combined HRT increase the risk of developing breast cancer, but it also increases the chances that the cancer will be discovered at a more advanced stage. This is due to its influence in reducing the effectiveness of mammography by creating denser breast tissue.
If you no longer have a uterus, estrogen alone can be given for symptoms of menopause. This probably does not increase your risk of developing breast cancer much, if at all. In March 2004, it was concluded from the WHI study that those taking estrogen only had no increased risk of breastcancer or heart disease; however, estrogen does appear to increase one's risk of stroke.
If you are considering HRT to relieve your menopausal symptoms, talk to your doctor to discuss the risks and benefits. Together you can decide what is right for you.
Hormone replacement therapy is an effective treatment for relieving hot flashes from menopause. But the known link between hormone therapy and increased breast cancer risk has discouraged many women and their doctors from choosing or recommending this treatment.
The type of hormone therapy (estrogen only or combination of estrogen and progestin), as well as the woman's individual characteristics, risk factors, and severity of menopause symptoms, should be considered when weighing the risks and benefits of HRT. The decision to use hormone therapy after menopause should be made by a woman and her health care provider after weighing all of the potential risks (including heart disease, breast cancer, stroke, and blood clots) and benefits (relief of menopause symptoms and prevention of osteoporosis).
See the article here:
Hormone Replacement Therapy Breast Cancer - WebMD
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Bioidentical hormones that may need to be balanced include:
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Hormone Replacement Therapy Doctor | Genemedics
Hormone replacement therapy (HRT) in menopause is medical treatment in surgically menopausal, perimenopausal and postmenopausal women. Its goal is to mitigate discomfort caused by diminished circulating estrogen and progesterone hormones in menopause. Combination HRT is often recommended as it decreases the amount of endometrial hyperplasia and cancer associated with unopposed estrogen therapy. The main hormones involved are estrogen, progesterone and progestin. Some recent therapies include the use of androgens as well.
The 2002 Women's Health Initiative of the National Institutes of Health found disparate results for all cause mortality with hormone replacement, finding it to be lower when HRT was begun earlier, between age 50-59, but higher when begun after age 60. In older patients, there was an increased incidence of breast cancer, heart attacks and stroke, although a reduced incidence of colorectal cancer and bone fracture. Some of the WHI findings were again found in a larger national study done in the UK, known as The Million Women Study. As a result of these findings, the number of women taking hormone treatment dropped precipitously. The Women's Health Initiative recommended that women with non-surgical menopause take the lowest feasible dose of HRT for the shortest possible time to minimize associated risks.
The current indications for use from the U.S. Food and Drug Administration include short-term treatment of menopausal symptoms, such as vasomotor hot flashes or urogenital atrophy, and prevention of osteoporosis. In 2012, the United States Preventive Task Force concluded that the harmful effects of combined estrogen and progestin are likely to exceed the chronic disease prevention benefits in most women. A consensus expert opinion published by the The Endocrine Society stated that when taken during perimenopause, or the initial years of menopause, hormonal therapy carries significantly fewer risks than previously published, and reduces all cause mortality in most patient scenarios. The American Association of Clinical Endocrinology also released a position statement in 2009 that approved of HRT in appropriate clinical scenarios.
There have been a number of large scale cross sectional and cohort studies on the effects of hormone replacement in menopause, the largest being in the United States, the United Kingdom and China. Demographically, the vast majority of data available is in post-menopausal American women with concurrent pre-existing conditions, and with a mean age of over 60 years.
In 2002 the Women's Health Initiative (WHI) was published. That study looked at the effects of hormonal replacement therapy in post-menopausal women. Both age groups had a slightly higher incidence of breast cancer, and both heart attack and stroke were increased in older patients, although not in younger participants. Progesterone is the major anabolic hormone for breast tissue, and accordingly breast cancer was not increased in patients who were on estrogen therapy alone after hysterectomy. Treatment with unopposed estrogen (the supplementation of endogenous estrogens without a progestogen) is contraindicated if the uterus is still present, due its proliferative effect on the endometrium. The WHI also found a reduced incidence of colorectal cancer when estrogen and progesterone were used together, and most importantly, a reduced incidence of bone fractures. Ultimately, the study found disparate results for all cause mortality with hormone replacement, finding it to be lower when HRT was begun during ages 5059, but higher when begun after age 60. Some findings of the WHI were reconfirmed in a larger national study done in the UK, known as The Million Women Study. Coverage of the WHI findings led to a reduction in the number of post-menopausal women on hormone replacement therapy. The authors of the study recommended that women with non-surgical menopause take the lowest feasible dose of HRT, and for the shortest possible time, to minimize risk.
These recommendations have not held up with further data analysis, however. Subsequent findings released by the WHI showed that all cause mortality was not dramatically different between the groups receiving conjugated equine estrogen (CEE), those receiving estrogen and progesterone, and those not on HRT at all. Specifically, the relative risk for all-cause mortality was 1.04 (confidence interval 0.881.22) in the CEE-alone trial and 1.00 (CI, 0.831.19) in the estrogen plus progesterone trial. Further, in analysis pooling data from both trials, post menopausal HRT was associated with a significant reduction in mortality (RR, 0.70; CI, 0.510.96) among women ages 50 to 59. This would represent five fewer deaths per 1000 women per 5 years of therapy.
A robust Bayesian meta-analysis from 19 randomized clinical trials reported similar data with a RR of mortality of 0.73 (CI, 0.520.96) in women younger than age 60. However, MHT had minimal effect among those between 60 and 69 years of age (RR, 1.05; CI, 0.871.26) and was associated with a borderline significant increase in mortality in those between 70 to 79 years of age (RR, 1.14; CI, 0.94 1.37; P for trend < 0.06). Similarly, in the HERS trial, with participants having a mean age of 66.7 yr, MHT did not reduce in total mortality (RR, 1.08; CI, 0.84 1.38). A 2003 meta-analysis of 30 randomized trials of menopausal HRT in relation to mortality showed that it was associated with a nearly 40% reduction in mortality in trials in which participants had a mean age of less than 60 yr or were within 10 yr of menopause onset but was unrelated to mortality in the other trials. The findings in the younger age groups were similar to those in the observational Nurses' Health Study (RR for mortality, 0.63; CI, 0.56 0.70).
The beneficial potential of HRT was bolstered in a consensus expert opinion published by the The Endocrine Society, which stated that when taken during perimenopause, or the initial years of menopause, hormonal therapy carries significantly fewer risks than previously published, and reduces all cause mortality in most patient scenarios. The American Association of Clinical Endocrinology released a position statement in 2009 that approved of HRT in the appropriate clinical scenario.
Proprietary mixtures of progestins and conjugated equine estrogens are a commonly prescribed form of HRT. As the most common and longest-prescribed type of estrogen used in HRT, most studies of HRT involve CEE. More recently developed forms of drug delivery include suppositories, subdermal implants, skin patches and gels. They have more local effect, lower doses, fewer side effects and constant rather than cyclical serum hormone levels.
The data published by the WHI suggested supplemental estrogen increased risk of venous emboli and breast cancer but was protective against osteoporosis and colorectal cancer, while the impact on cardiovascular disease was mixed. These results were later confirmed in trials from the United Kingdom, but not in more recent studies from France and China. Genetic polymorphism appears to be associated with inter-individual variability in metabolic response to HRT in postmenopausal women.
Originally posted here:
Hormone replacement therapy (menopause) - Wikipedia, the ...
If youre looking for relief from menopause symptoms, knowing the pros and cons of hormone replacement therapy (HRT) can help you decide whether its right for you.
HRT (also known as hormone therapy, menopausal hormone therapy, and estrogen replacement therapy) uses female hormones -- estrogen and progesterone -- to treat common symptoms of menopause and aging. Doctors can prescribe it during or after menopause.
After your period stops, your hormone levels fall, causing uncomfortable symptoms like hot flashes and vaginal dryness, and sometimes conditions like osteoporosis. HRT replaces hormones your body no longer makes. Its the most effective treatment for menopause symptoms.
You might think of pregnancy when you think of estrogen. In women of child-bearing age, it gets the uterus ready to receive a fertilized egg. It has other roles, too -- it controls how your body uses calcium, which strengthens bones, and raises good cholesterol in the blood.
If you still have your uterus, taking estrogen without progesterone, another pregnancy-related hormone, raises your risk for cancer of the endometrium, the lining of the uterus. Since the cells from the endometrium arent leaving your body during your period any more, they may build up in your uterus and lead to cancer. Progesterone lowers that risk by thinning the lining.
Once you know the hormones that make up HRT, think about which type of HRT you should get:
Estrogen Therapy: Doctors generally suggest a low dose of estrogen for women who have had a hysterectomy, the surgery to remove the uterus. Estrogen comes in different forms. The daily pill and patch are the most popular, but the hormone also is available in a vaginal ring, gel, or spray.
Estrogen/Progesterone/Progestin Hormone Therapy: This is often called combination therapy, since it combines doses of estrogen and progestin, the synthetic form of progesterone. Its meant for women who still have their uterus.
The biggest debate about HRT is whether its risks outweigh its benefits.
Originally posted here:
Menopause and Hormone Replacement Therapy - WebMD
For decades, women have used hormone therapy to ease symptoms of menopause, such as hot flashes and sweating. This is called menopausal hormone therapy, and you may see it abbreviated as HT or MHT. You may also hear it described as hormone replacement therapy (HRT), postmenopausal hormone therapy (PHT), or postmenopausal hormones (PMH).
In the past, many doctors and their patients believed that MHT didnt just help with hot flashes and other symptoms it had important health benefits. But well-conducted studies have led many doctors to conclude that the risks of MHT often outweigh the benefits.
This document discusses only how MHT can affect a womans risk of getting certain cancers. It does not discuss other possible risks of MHT such as heart disease or stroke.
You can use this information when you talk to your doctor about whether MHT is right for you.
Menopause is the time in a womans life when the ovaries stop working and she stops having menstrual periods for good. Menopause is sometimes called the change of life, or the change.
The ovaries stop releasing eggs and making the female hormones, estrogen and progesterone. In the months or years leading up to natural menopause, menstrual periods may become less frequent and irregular, and hormone levels may go up and down. This time is called perimenopause or the menopausal transition. Since periods can become less frequent during this time, it can be hard to know when they have actually stopped (and you have gone through menopause) until you look back at a later time.
Women who have their ovaries removed by surgery (oophorectomy) or whose ovaries stop working for other reasons go through menopause, too, but much more suddenly (without the menopausal transition).
Women who have had their uterus removed (hysterectomy) but still have their ovaries stop having periods, but they dont really go through menopause until their ovaries stop working. This is often determined based on symptoms, but your doctor can tell for certain by testing your blood for levels of certain hormones. Hormones made by the pituitary gland called luteinizing hormone (LH) and follicle stimulating hormone (FSH) help regulate the ovaries before menopause. When levels of estrogen get lower during menopause, the levels of FSH and LH go up. High levels of FSH and LH, along with low levels of estrogen, can be used to diagnose menopause. Blood tests for these may be helpful in a woman who has had her uterus removed.
Some drugs can turn off the ovaries and cause menstrual periods to stop for a time. Although this is not the same as menopause, it can lead to many of the same symptoms.
Most of the symptoms of menopause are linked to lower estrogen levels. Some symptoms hot flashes and night sweats, for instance tend to fade away at some point, whether or not they are treated. Other problems that start after menopause, like dryness and thinning of vaginal tissues and bone thinning, tend to get worse over time.
Menopausal Hormone Therapy and Cancer Risk
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We offer a variety of optimal aging and integrative wellness programs, all tailored to your individual needs, and all overseen by Dr. Gaines himself.
AAG HealthGAINS has always been a pioneer in evidence-based, scientifically proven age management techniques and programs. We are often the very first in your area to offer cutting-age anti-aging treatments, while other facilities struggle to play catch-up. We are dedicated to helping you achieve your peak performance at any age, and to adding more years to your life, and more life to your years!
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Hormone Replacement Therapy | Growth Hormone, Testosterone