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HRT once relieved hot flashes — now it’s taking heat

Bookmark and Share In the midst of the media frenzy over menopause and hormone replacement therapy, there is only one constant: All women eventually go through menopause, but not all women will experience the same symptoms. The real dilemma is how women will manage these symptoms when the time comes. Some women may choose medication or supplements — some, nothing at all. What's most important is that women take an active role in deciding what's best for them. What's all the hype?
What's right for me?
Health risks vary
It's a personal decision

What's all the hype?
In July 2002, the National Institutes of Health (NIH) stopped a major clinical study with postmenopausal women who were taking estrogen combined with progestin. The study, which is part of the Women's Health Initiative (WHI), reported an increased risk of breast cancer, cardiovascular disease, stroke and blood clots in study participants who were taking the combination compared to women taking placebo pills. Although the study found a 26% increase in breast cancer, meaning there were about eight more cases annually than expected among 10,000 women on combined HRT. It also found a 22% increase in cardiovascular disease, including a 29% increase in heart attacks. This translates into an additional seven heart attacks, eight strokes and 18 blood clots a year among 10,000 women. What's right for me?
Knowing these risks, women still want to know what they can do to relieve menopause symptoms. "If you are currently taking HRT, talk with your doctor about your treatment options," advises Jeffry Komins, MD, chief of obstetrics and gynecology at Virtua Memorial Hospital Burlington County. "This may seem like standard advice, but it has never been more important. Together, you will need to discuss your personal and family medical history, the severity of your symptoms and the risks versus the benefits of continuing HRT or choosing alternatives." Health risks vary
Health risks vary with the individual. Experts agree that short-term HRT use appears to be safe for healthy women. Cancer risk increases after several years of HRT use. "Women should visit their physicians at least once a year for a checkup," suggests Bernard J. Cortese, MD, board-certified obstetrician/gynecologist at Virtua Health. "Your doctor is your best guide for helping you to monitor and reduce the effects of menopause. As part of your regular exam, get a lipid profile to screen for the risk of heart disease and a bone density scan for osteoporosis. You can also help control menopause symptoms with regular exercise, smoking cessation, a low-fat diet and medical therapy if necessary." It's a personal decision
Even with a wealth of education and your doctor's best advice, the decision to continue with or start hormone replacement therapy lies with you. "If your symptoms are intolerable, short-term use of hormones may be your best option," advises Dr. Komins. "But if you want to stop taking HRT all together, meet with your physician to develop the best plan to ease your symptoms." To make an appointment with a Virtua gynecologist, call 1-888-Virtua-3.