The Complete Menopause Presents: THE TRUTH ABOUT HRT DISCLAIMER

Transcription

1 The Complete Menopause Presents: THE TRUTH ABOUT HRT DISCLAIMER None of the information in this report is intended to diagnose, treat or cure any disease or illness. This book is not intended to take the place of any established medical practices nor in any way replace any authorized medical advice. Always seek out the opinion and diagnosis of your personal physician before implementing any health-related regimen. All information in this report is copyright to The Complete Menopause 2010

2 In today`s society, menopause is often approached from a negative point of view. It is seen as a time of loss the loss of the monthly period, the loss of fertility, hormones, youth, confidence whereas in other societies, this stage in a woman`s life is viewed as a positive thing. Older women are seen as having maturity, experience and wisdom and their advice and guidance is highly valued. They are quite rightly recognised as having a valuable and unique contribution to make to their friends, family and society. When I was deciding whether hormone replacement therapy was the right option for me, it took days if not weeks of research. The problem was that I had heard so much conflicting information, that I was totally confused. I wanted to know what the risks were, as well as the benefits. What options were available to me, how would I decide if I was suitable for treatment and what were the alternatives. You will of course probably have many other questions and that is why I have put together this free report. It may not address all of your concerns, but you will certainly have enough knowledge at the end of it to make an informed decision about whether hormone therapy is the right choice for you. What Is HRT? As we reach menopause age usually around 51 the hormone levels in our body change, causing symptoms such as hot flashes, bloating, weight gain and mood changes. Hormone therapy replaces the estrogen and progesterone and can help relieve the symptoms. The Main Types Of HRT There are currently over 50 different preparations of hormone replacement therapy, but the three main ones are: Estrogen Only HRT If you have had your womb and ovaries removed after having a hysterectomy, estrogen only therapy will usually be recommended. The fact that you no longer have a womb means that you do not need to take progestogen as there is no risk of endometrial cancer (cancer of the womb lining). 2

3 Cyclical HRT Copyright: The Complete Menopause 2010 Cyclical or sequential HRT is recommended for women who have been through a natural menopause, or who are close to menopausal age and still having periods, but also experiencing menopausal symptoms. There are two types of cyclical therapy: Monthly HRT is where you take estrogen every day, plus, you take progestogen at the end of your menstrual cycle for 14 days. This is usually recommended for women who still have regular periods. You will continue to have them until menopause causes them to stop. Three-monthly HRT, means that you take estrogen every day and also take progestogen for 14 days every 13 weeks. This is recommended for women who have irregular periods. With this therapy, you should experience your period every three months. Continuous Combined HRT Continuous combined HRT is usually recommended for women who have been through the menopause. If you have not had a period for a year, you are post menopausal. Continuous HRT involves taking estrogen and progestogen every day, with no break. Unlike cyclical therapy, it doesn`t cause regular bleeding. Starting Hormone Therapy When you are beginning HRT, aim to start with a relatively low dose and keep a note of how it affect you symptoms and your well being. You can always increase your dose if necessary, until you establish the right balance for your needs. Contact your medical professional if you experience any side effects or have any concerns. How Is HRT Taken? There are many alternative ways to take replacement therapy: Tablet taken daily Patches 3

4 Implant inserted under a local anaesthetic Cream or gel applied to the skin or vagina to ease dryness Nasal spray Vaginal ring What Symptoms Does It Treat? Hormone therapy can help reduce the intensity and the severity of hot flashes and night sweats. It is sometimes taken for a period of 6 months in order to relieve very bad hot flashes. It offers relief from vaginal dryness. Women often report feeling healthier and more positive. Although, HRT is not a magic wand to improve emotional issues due to outside influences. Long term benefits include a reduced risk of osteoporosis and, for combined HRT, a reduced risk of colorectal cancer. HRT is usually recommended for two to three years. Although, symptoms can return for a short time after treatment is stopped. What About My Periods? If your periods have not yet stopped when you start HRT, it is important that you have a regime which includes estrogen and progestogen and is given in a sequential manner so that your periods will continue. This will produce a bleed towards the end of each pack, or at the beginning of the next pack in over half of users. If you have been taking sequential HRT for several years, or have reached the age of 54 and wish to continue HRT, it can be changed to continuous combined, or period free HRT. This provides both estrogen and progestogen every day and although some bleeding in the first 6 months of therapy is quite common, it doesn't usually cause bleeding thereafter. 4

5 Side Effects Of HRT Copyright: The Complete Menopause 2010 There has always been concern about the side effects of hormone therapy and they must be considered seriously when deciding if this is the best option for you. However, if you do proceed and problems persist after three months, consult your medical practitioner. Bleeding HRT taken in the peri-menopause stage is usually in the form of daily estrogen with cyclical progestogen. This induces a monthly bleed in most women, which may initially be heavy or irregular, but which will usually settle after the first few months. Bloating Fluid retention and bloating can be made worse with hormone therapy. Maintaining a healthy weight can help, but otherwise changing the type or dose might be prudent. Weight Gain Weight gain around the time of the menopause is perfectly normal and a very unwelcome symptom for most women. I know of women who refuse point blank to take HRT for fear of gaining weight, but there is no scientific evidence that HRT causes weight gain. There are a few women who may develop fluid retention with HRT and gain weight initially, but it will usually disappear in four to six weeks. Choose the Menopause as a time of life to try and bring out the best in yourself. Take more exercise and eat a healthier diet. This will not only make you feel better about yourself, but will also help you cope better with menopausal symptoms. Premenstrual Syndrome If you suffer or have suffered from PMS, the bad new is that it can often get worse in the years leading up to menopause. Once again, this is due to fluctuation hormone levels and HRT may help reduce or eliminate this particular symptom. Sequential therapy may also cause PMS type symptoms. 5

6 Nausea Feelings of sickness and nausea can be helped by taking tablet HRT at night with food instead of in the morning. Risk Factor There has always been controversy surrounding the risks and side effects of hormone therapy, so let`s take a look at them. Stroke And Heart Disease It is widely accepted that "HRT carries a small risk of stroke and heart attacks because it increases the risk of abnormal blood clotting and raised blood pressure". However, there is apparently no increased risk with estrogen only therapy. For women taking combined HRT, there is an increased risk only in women who were twenty or more years post menopausal and the increase was in the first year. When hormone therapy was first introduced, it was thought that it prevented heart disease and strokes. Recent research has shown that this is not the case, although it does seem that the treatment offers some protection against developing bowel cancer. In conclusion, HRT used in the early menopausal years is very unlikely to be harmful to the heart. Breast Cancer Increased risk of breast cancer associated with the long term use of hormone therapy (five years or more) is well known. Although, combined HRT appears to increase the risk more than estrogen only therapy. However, the risk appears to return to normal within five years of stopping hormone therapy. In the UK, the Million Women study found that: In women aged 50 who do not use HRT, about 32 in every 1000 will be diagnosed with breast cancer by the time they reach the age of 65. For women who start estrogen only HRT at the age of 50 and use it for five years, around 33 to 34 in every 1000 will be diagnosed with breast cancer by the age of 65. 6

7 In women who start combined HRT at the age of 50 and use it for five years, the figure would be 38 in every For those who start estrogen only HRT at the age of 50 and use it for 10 years, breast cancer will be diagnosed in 37 in every 1000 by the age of 65. In those women who start combined HRT at the age of 50 and use it for 10 years, the figure increases to 51 in every Although breast cancer detected in women taking hormone therapy is more treatable, many now advise against taking HRT for longer than five years. Recent recommendations are that hormone therapy is used only as a short term treatment to relieve menopausal symptoms. Furthermore, it is advised that treatment is reviewed at least annually. Clotting Problems As hormone replacement therapy has been shown to slightly increase the risk of blood clots such as deep vein thrombosis, it may be advisable to avoid using if there family history of blood clot. The greatest risk is within the first year of use and is most relevant to women who have other risk factors. Endometrial Cancer This is cancer of the womb lining and your chances of contracting it, increase significantly when you take estrogen only HRT. On the other hand, sequential HRT (daily estrogen combined with progestogen) taken for 10 to 14 days per month reduces this risk but does not totally eliminate it. Ovarian Cancer Cancer Research UK states that Taking HRT slightly increases the risk of developing ovarian cancer The longer HRT is taken, the more the risk increases However: When the HRT is stopped, the risk goes back down to normal over a few years 7

8 When HRT Is Not Suitable Balancing the risks of hormone therapy against the benefits, is something that every woman will need to do before deciding if HRT is right for you. Some conditions may mean that you are not suitable for HRT. You have a history of breast, ovarian or endometrial cancer You have a history of blood clots or have suffered recent clots in the leg or the lung You or your family have a history of heart disease or stroke or you suffer from angina You suffer from high blood pressure (your blood pressure will need to be controlled before you can start HRT) You have liver disease You have undiagnosed vaginal bleeding You are pregnant Alternatives to HRT For many women, the benefits outweigh the risks, but for some, alternative treatments for either symptom control or osteoporosis may be preferred. If you are unable or unwilling to take hormone therapy, there are alternative approaches and treatments that you may like to consider: B Vitamins Quite often, people who are always grumpy, tense, irritable or stressed out, will be suffering from a deficiency of the B group of vitamins. Poor concentration and low energy levels can also be an indication of a deficiency. During menopause it is extremely important that you assist your adrenal glands, which will be required to produce estrogen. The B vitamins group will help to do this. Vitamin C Well known as an anti oxidant and for its beneficial effect on the immune system and the skeleton. Vitamin C is not only important for preventing illness, and for encouraging your good health, but it can also help relieve hot flashes when taken with bioflavonoids. 8

9 Vitamin C will help to build up collagen - which gives skin its elasticity - and it is a good vitamin to take, to help prevent and treat vaginal dryness. It can also help maintain elasticity in the urinary tract and so prevent stress incontinence, which is another common menopausal symptom. Vitamin E Known to help reduce the severity and occurrence of hot flashes, vitamin E is also beneficial to easy vaginal dryness. In fact onestudy showed that 400iu of vitamin E taken daily for up to four months, improved the symptoms by approximately fifty per cent. Essential Fatty Acids(EFAs) Essential Fatty Acids are essential in preventing dry skin, limp hair, cracked nails, depression, fatigue, lack of motivation and aching joints. These are also all conditions that could be mistaken for menopausal symptoms. It is particularly important that you are getting your share of EFA`s at the time of menopause, because they can help with many of the associated symptoms Lifestyle changes By making small changes to your lifestyle, you should notice a reduction in some symptoms, but you will certainly notice an improvement in your overall feelings of well being: Regular Exercise Offers many benefits, but will help reduce hot flashes, night sweats and improve sleep. Regular exercise is also a great confidence giver as you will look and feel better. It`s also a great way to cheer yourself up. Stay Cool By wearing loose clothing and sleeping in a cool, well-ventilated room, you will help relieve hot flashes, night sweats and insomnia. Cut Down(or out) Caffeine, alcohol, spicy food and tobacco. All are known to trigger hot flashes. By quitting smoking you are also reducing your risk of developing heart disease and cancer. 9

10 Bioidentical Hormones So, what if you don't fancy using a treatment that is based on pregnant mares urine, as HRT is? Or perhaps you`re concerned about the links with breast cancer and associated side effects such as breast tenderness or bleeding. Is there a viable alternative? Well, yes and no. There is a new kid on the block that is gaining popularity amongst menopausal women although they have been around for years, many practitioners are unfamiliar with them. Bioidentical hormones are plant based and manufactured in the laboratory to have the same molecular structure as the hormones made by your own body. Aslo, the compounded bioidentical hormones can be matched individually to each woman s needs rather than a one size fits all approach as with mass produced products. Unfortunately this brings its own problems. As many preparations are made specifically for the individual client, based on her unique physiology, they cannot be regulated by the FDA. This means that there are no tests on their safety or effectiveness. And as far as I am aware, there are no comparisons between bioidentical and traditional HRT, to determine whether one is more effective than the other. As with HRT, bioidentical hormones can work wonders, but they aren t necessarily the first place to turn when hormonal imbalance is a problem. Diet and lifestyle considerations should always be important factors when considering the best course of action. Also remember, that no hormones should be used long-term unless you have consulted with your practitioner and followed his recommendations. Are Bioidentical Hormones Safer Than Synthetics? Early studies have suggested that they may indeed be safer than their synthetic counterparts, but we must be cautious. There have not been many studies on bioidentical hormones, especially their long term effect. And it is always prudent to think in terms of no drug being completely safe. 10

11 If you decide to purse this particular therapy, it is vital that you seek the advice of a medical practitioner who has had extensive experience in this field. Common Misconceptions Below are some of the common misconceptions about HRT: I ve tried HRT and it didn t work As there are many different types of HRT that can be taken in a number of different ways, it may be necessary to try different formulations to find the one most suitable for you. If I m on HRT so I can t get pregnant Not true. You can still get pregnant when you are taking HRT. When To Stop Taking HRT Most women are advised to stop taking HRT once their menopausal symptoms have finished. It is usually recommended that you decrease your dose gradually over time, rather than stopping suddenly. You may experience some menopausal symptoms, but these should fade away in a few months. If any symptoms persist for several months after stopping HRT, or if they are particularly severe, contact your medical practitioner as your treatment may need to be restarted. It can usually be restarted at a lower dose. 11

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