Hormone Therapy (cont.)
Who should take hormone therapy (HT)?
- Women with hot flashes
, especially when they are causing sleep disturbance, should
consider hormone therapy (HT). Estrogen given short-term is the most effective treatment for hot
flashes, and benefit of short-term (less than 5 years) use outweighs potential
risks for most women.
- Because the risks outweigh the benefits of long-term
hormone therapy (HT) for most women, women who are at risk of, or who have been diagnosed with,
osteoporosis should talk to their doctors about non-estrogen medications such
as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista),
teriparatide (Forteo), and calcitonin (Miacalcin) in preventing and treating osteoporosis.
- Women with vaginal dryness or itching due to menopause. Oral pills, skin
patches, gel, or vaginal forms of estrogen can be used. Women who only have
vaginal menopause symptoms and are not experiencing hot flashes should pick a
vaginal form of estrogen, whereas women with both hot flashes and vaginal
symptoms can use any form of ET. Sometimes, if a woman has both hot flashes and
vaginal symptoms, both oral and vaginal forms of ET will be prescribed together,
especially if vaginal symptoms do not improve with oral ET alone.
Who should not take hormone therapy (HT)?
- Contrary to common myth, women with high blood
pressure that is controlled by medication can take hormone therapy (HT) because
hormone therapy (HT) does not
cause significant elevations in blood pressure. A major medical reason for not
taking hormone therapy (HT) is a personal medical history of breast cancer or uterus cancer. Women with abnormal
vaginal bleeding should have an evaluation prior to embarking on hormone therapy
(HT) to exclude
the presence of cancer of the uterus. Similarly, routine mammograms and breast
examinations are important to exclude the presence of breast cancer.
- While hormone therapy (HT) may be used in women with migraines or liver
disease, certain types of hormone therapy (HT) (often
a patch or vaginal form) may be chosen to try to avoid aggravating these
conditions.
- Women should not be taking hormone therapy (HT) to prevent heart
disease, and should initiate hormone therapy (HT) only with caution if they already have been
diagnosed with coronary artery disease (such as past heart attack), as
hormone therapy (HT) may be increase the risk of
heart attacks.
- Women with a personal history of deep vein thrombosis
(blood
clots in the veins) should avoid hormone therapy (HT).
Next: What medical checkups are advised for women on hormone therapy (HT)? »
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