WOMEN: HOW CAN MENOPAUSAL SYMPTOMS BE RELIEVED?
All menopausal problems due to a lack of oestrogen can be corrected by hormone replacement therapy (HRT). Germaine Greer won’t like me for saying this. We’ll discuss the philosophical arguments for and against HRT presently.
Hormone replacement therapy
Studies on many hundreds of thousands of women have proved that HRT relieves oestrogen deficiency symptoms and can prevent or greatly reduce adverse effects on health due to a lack of oestrogen. Its benefits include the following.
• HRT eliminates physical symptoms due to a lack of oestrogen.
• Women feel psychologically better on HRT: they have more energy and vitality to enjoy life and cope with its ups and downs; less depression mood disturbances.
• HRT maintains healthy genital skill vaginal lining, making these tissues less liable to inflammation and infection. Lack of oestrogen causes the genital] vaginal membranes to become thinner, drier and less elastic. During sex, lubrication is slower and penetration may hurt. This may put you off sex, a time when you and your partner have more time to enjoy this part of your relationship. Your partner may feel rejected if you avoid sex because it is painful: many a relationship has foundered due to such misunderstandings and quite unnecessarily.
• By helping to maintain the tone of the pelvic muscles, HRT can help to prevent bladder control from worsening after the menopause.
• Oestrogen reduces the risk of cardiovascular disease and severe osteoporosis.
What HRT won’t do HRT won’t (alas!) prevent grey hairs and wrinkles. It also won’t solve emotional upsets due to marital, family and other interpersonal conflicts, or the many other worries and disappointments that invade our lives. But it may help you to muster more emotional and physical energy to deal with these problems.
Are there any health risks
HRT? For most women the advantages of HRT outweigh any possible disadvantages. There are a few women, including those with a history of breast cancer, some types of thrombosis, a rare type of migraine, severe liver disease and some gall bladder diseases, for whom hormonal treatment is inadvisable. Other measures can help relieve menopausal symptoms for these women. It used to be suspected that HRT might cause problems with blood pressure and blood fats such as cholesterol. More recent studies have shown that the reverse is true — HRT is of real benefit to women who have risk factors for heart disease such as high blood pressure and increased blood cholesterol.
Can HRT cause cancer? When HRT first introduced, it was found that women who took oestrogen alone for a long time developed cancer of the lining of the uterus more often than women who took no hormones. A vast amount of research has now shown that if oestrogen is combined with regular supplements of progestogen, there is no increased risk of uterine cancer.
There has been some uncertainty about whether HRT may be associated with the risk of breast cancer in susceptible women. There is growing evidence that use of HRT for more than 10 years slightly increases the risk of breast cancer, but that women who are on HRT at the time breast cancer is diagnosed have a better chance of surviving longer than those who aren’t.
The important thing is to balance up the risks and benefits for each individual, for example, if a woman has increased risk of coronary heart disease or osteoporosis, the preventive health benefits of HRT far outweigh any increased risk of breast cancer. Women who have no oestrogen deficiency symptoms and who are not at increased risk of heart disease or osteoporosis should consider the slight increase in risk of breast cancer when deciding whether or not to take HRT.
There is no known link between HRT and increased risk of any other type of cancer. There is evidence that HRT may reduce the risk of colon (large bowel) cancer and ovarian cancer.
*198/31/5*
