Sunday, March 17, 2013

HRT for Menopause?

This article I saw on Yahoo News is an example of why patients ought not to go scouring the Internet for all their medical information.  The title of the article "Doctors Clear Up Confusion Over Hormone Therapy" is rather misleading.  Hormone replacement therapy (i.e. supplement estrogen and progesterone pills) has long been known to be the best intervention for refractory menopausal symptoms.  Unfortunately, a Women's Health Initiative study from a decade ago demonstrated that subsets of post-menopausal of women who took hormonal replacement therapy (HRT) medication increased their risk of developing breast cancer by 25%.  Afterwards, enthusiasm for HRT sort of tapered off.  As you could imagine.  This new statement avers that:
...while the therapy comes with risks, its benefits generally outweigh the harm for women under age 60, or those who've been in menopause for fewer than 10 years. The increased risk of breast cancer also appears to disappear a few years after treatment is stopped......doctors recommend low doses of HRT for women whose menopausal symptoms are limited to vaginal dryness and pain during intercourse. HRT is not recommended for women who've had breast cancer
So if you're under 60, have had symptoms less than 10 years, never had breast cancer,  and your symptoms are limited to vaginal dryness and dyspareunia, then HRT is for you.  I'm a little wary myself.  Curiously absent from the "consensus statement" are doctor's groups such as the American Medical Association, the National Cancer Institute, the American Cancer Society, the American Society of Breast Surgeons, and the American Breast Cancer Foundation.  The Asia Pacific Menopause Society, which I'm sure is a fine organization, just doesn't have the carry the same cache for me.... 

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