(HRT) HORMONE REPLACEMENT THERAPY
MENOPAUSE:
Menopause is defined as the women’s last menstrual period.
The changes that take place around the menopause are usually present over a number of years. It occurs anywhere between 40 to 60 years of age and the average age is about 51 years in Australia.
The periods can become a little infrequent and irregular. They may even become heavier before they stop altogether. Around this time which is the “perimenopause”, women may experience some symptoms of the menopause. The most common is that of hot flushes. Oestrogen is the hormone level that keeps a female “a woman”. Its actions are on the skin, heart, brain, breasts and uterus. As the menopause approaches the amount of oestrogen fluctuates and may cause alternate breast tenderness and hot flushes on other days.
PERIMENOPAUSE:
This is the time when the body changes into the transition before the menopause. Often periods may become irregular and the body has a gradual reduction in the amount of oestrogen that it produces.
Once periods have stopped for over 12 months then one has reached the menopause.
SYMPTOMS OF THE MENOPAUSE:
Many of the symptoms begin to occur while a women still has periods. The most common are:-
- night sweats and poor sleep
- hot flushes
- anxiety and palpitations.
- vaginal dryness
- weight gain
Some of these symptoms may last for years.
THE MOST OBVIOUS AND EASIEST WAY TO TREAT THE CHANGES OF THE MENOPAUSE IS TO REPLACE THE OESTROGEN THAT HAS BEEN LOST. HRT DOES THIS.
Hormone replacement therapy (HRT). This is a method of replacing oestrogen that the ovaries have stopped producing. It will reduce most of the symptoms of the menopause. It will help hot flushes, night sweats and painful intercourse. In general terms women who have not had a hysterectomy will require both oestrogen and progesterone. However, if a hysterectomy has been performed in the past then only oestrogen is necessary.
There are various doses and forms of HRT and the appropriate dose and type of HRT will need to be decided according to the individual’s situation.
OSTEOPOROSIS:
From the time of menopause, the bones lose calcium. During the first 5 or 10 years after the a family history and a thin build which will increase the risk of osteoporosis. Certain other factors such as smoking, alcohol, caffeine and poor diet will accelerate this loss.
Oestrogen replacement is one of the easiest ways of improving or decreasing this bone loss.
RISKS OF HRT:
In 2003 there was a WHI study conducted in the United States. This showed that there was an increase in coronary heart disease, venous thrombosis, breast cancer and ovarian cancer if one uses HRT for 5 years or more. The design of the study in the United States was with women between 50 and 79 years of age. The patients in this study often had chronic disease such as hypertension and diabetes. One therefore hesitates to extrapolate those results to Australian women around the age of 50 or 60 years.
Obviously all these issues will be discussed at a consultation.
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