As a woman approaching mid-life, your body is undergoing changes. The hormones that once existed in such vast amounts begin to dwindle as you pass childbearing years, and they’ll continue to dwindle throughout the rest of your life. These changes can have uncomfortable side effects, including hot flashes, mood swings, and even depression.
Hormone replacement therapy (HRT) can make a big difference in counteracting these symptoms, replacing the diminished hormones in a natural way. However, HRT is not without risks. You should carefully consider these risks before deciding if HRT is the best treatment for your symptoms.
In your childbearing years, your ovaries produce estrogen and progesterone. This regulates your reproductive cycle and promotes the body’s use of calcium. The ovaries produce these hormones in decreasing amounts as you age, often resulting in bone loss, diminished sex drive and energy, mood swings, and other symptoms.
Hormone replacement therapy seeks to return those hormones to the body in order to lessen symptoms. Through successful hormone replacement therapy, you’re able to live a more productive and comfortable life, well into your later years.
While some risks are associated with HRT, some health benefits have been discovered as well. HRT has been linked to reduction of: heart disease, diabetes, tooth loss, certain cancers, and cataracts.
How Is HRT Taken?
In the early years of HRT, doctors prescribed it in the form of synthetic prescription medication. Premarin is the synthetic form of estrogen, while progesterone is generally prescribed as Provera. The synthetic progesterone is called “progestin.” However, some risks were identified in trials that led many patients to seek out an alternative form of HRT, called “bioidentical HRT.”
Bioidentical HRT is becoming more popular, as women are concerned with the risks identified with synthetic HRT. In bioidentical HRT, a pharmacist compounds a special blend of hormones intended to replace the depleted hormones in your body. Bioidentical hormones are generally created from elements found in nature. Hormone replacement therapy can be administered orally or via cream, suppository, or injection.
The Cancer Link
The studies that have found a link between HRT and breast cancer refer to patients treated with synthetic HRT, not bioidentical HRT. However, there are no studies which show that bioidentical HRT is any safer than synthetic HRT. The risk of breast cancer increases the longer a woman engages in HRT, and the risk begins to decrease once HRT stops. Uterine cancer risks also exist when menopausal women with a uterus take estrogen only, which is why doctors will generally prescribe accompanying progestin. If you’ve had a hysterectomy, you can forego the progestin and simply take estrogen.
Other risks for women undergoing HRT include osteoporosis and stroke. This is especially prevalent among postmenopausal women, which is why synthetic HRT is now mostly used for short-term relief of menopause symptoms. It’s important to note that the risks of osteoporosis exist in menopause without HRT, and that with the right combination, osteoporosis risks can actually be decreased.
Bioidentical Hormone Replacement Therapy
Whether or not bioidentical HRTs have the same risks as synthetic HRTs is unknown. Some experts say that bioidentical HRT is a more natural method and therefore safer, but since it hasn’t undergone the same rigorous studies as synthetic HRT, there’s no definitive answer.
Created through extracts from soy and yams, bioidentical hormones operate on the theory that your body is unable to differentiate between these injected substances and the natural hormones your body creates. This way of “tricking” your body into its former state has been shown to be successful in many patients. However, the medical community still doesn’t know exactly how much of each hormone is needed, so hormone replacement therapy may involve multiple doctor visits and regular tests to determine the level of HRT dosing that is right for you.
Because each “cocktail” must be tailored to the individual patient, bioidentical hormones are difficult to test for safety and effectiveness on an overall basis. However, trials can be conducted on synthetic HRT on an overall basis, as the same compound is used.
You may find that your insurance company will balk at paying for bioidentical hormone replacement therapy but not at covering the same therapy in synthetic form. Because bioidentical hormones are compounded, some insurance companies refuse to cover them. Check to make you’re your insurance company covers bioidentical HRT and get an estimate of the cost before beginning therapy.