Therapy Duration and Safety of Hormone Replacement

If you take hormone replacement therapy, how long do you actually need it?

Most women still complain of menopausal symptoms brought about by estrogen deficiency even after ten years of after the start of menopause. They may still feel the discomforts of hot flashes, vaginal dryness, sweating and loss of sexual desire and enjoyment. Many of these symptoms last for different periods of time in different people, so the appropriate duration of hormone replacement therapy for the relief of these acute menopausal symptoms varies, depending on what the individual woman needs.

For the purpose of preventing osteoporosis, estrogen replacement therapy must be taken for a period of fifteen to twenty years. Taking estrogen protects the bones against disease, but this protections ceases once estrogen therapy is halted. Many physicians therefore believe that women at risk of developing osteoporosis should stay on estrogen replacement for life, provided they feel well and have regular check-ups. Furthermore, it is never too late to initiate hormone replacement therapy. Some women can still benefit if they start it in their sixties or seventies.

It is known that less than one third of post menopausal women continue on hormone replacement therapy over the long term. This is because many women are uncomfortable about a long-term commitment to hormone replacement, as there is continuing controversy as to whether it may case an increased risk of breast cancer or liver disease. The duration of this form of treatment is a very individual matter that needs to be reviewed regularly throughout the post menopausal period. Ultimately, the length of time you take hormone replacement should be your informed choice. You will need to communicate with your doctor before you decide what is right for you.

So what if you get side effects?

Oftentimes, adverse effects of hormone replacement therapy are minor and can be overcome by trying smaller doses of hormones or taking a different form of hormone replacement. Very rarely, high doses of the oral forms of this treatment can cause thrombosis (the formation of a blood clot or clots in your blood vessels) and this may produce pain and swelling in the legs. It can also bring about migraine headaches in women who are predisposed to them and the migraines can be preceded by disturbances in vision and speech or by limb weakness. This is not common, but if it occurs, you should immediately stop taking hormone replacement therapy and consult your physician. Women more prone to such side effects are those who smoke, who are obese and who have high blood pressure, varicose veins, or a past medical history of blood clots or stroke.

Some women on estrogen therapy complain of a mild to moderate weight gain. This is because hormone replacement therapy may cause a slight increase in appetite and fluid retention. This side effect can be avoided by reducing the dose hormones, avoiding strong masculinizing progestogens such as norgestrel and norethindrone, reducing the amount of saturated fat in the diet and getting regular exercise.