BENEFITS.
RISKS.
SIDE EFFECTS.

If you’re confused about hormone replacement therapy (HRT), you’re not alone. There are volumes written on HRT – the combination of estrogen/progesterone therapy – and much of the information is conflicting. Some women believe in HRT while others would never dream of taking hormones. The bottom line is that whether or not to take HRT is an important medical decision that every woman should make in collaboration with her doctor, based on her own unique physiology.

The most compelling reasons  to take HRT include:

(1) lessening, if not stopping, aggravating menopausal  symptoms, such as hot flashes, mood swings, painful sexual  intercourse due to the thinning of the vaginal walls, and frequent urinary tract infections;

(2) improving concentration and short-term memory;

(3) helping stem the loss of  bone mass and preventing osteoporosis; and

(4) working in various ways  to be a potent protection  against coronary  artery disease.

Recent studies show that HRT  is linked to a lower rate of Alzheimer's disease, a significant reduction in the risk of colon  cancer, and may even help to  prevent macular degeneration,  the most common cause of blindness in the elderly. Estrogen also helps to maintain skin thickness and moisture.

HRT is not for all women. Some studies have linked HRT to an increased risk of breast cancer. However, the North American Menopause Society believes that there are not enough data to make  a more definitive statement about such a risk. Some researchers  and physicians believe that the benefits of HRT outweigh the risks, especially for those women at high risk of heart disease and osteoporosis. Most experts do agree on who should not take HRT ...

(1) women with a history of  estrogen receptor positive  breast cancer;

(2) any woman with a history of clotting disorders such as thrombophlebitis - a condition in which blood clots lodge in the veins, usually in the legs; and

(3) any woman who can't tolerate the possible side effects of HRT such as weight gain, breast tenderness and/or mood changes.

Some women suffer no side effects from HRT. Others can experience bloating, weight gain, breast tender-ness, headaches, depression, or nausea. Most of these can be  remedied by modifying diet, increasing exercise, and/or adjusting the HRT dosage. The goal is to work with your physician to find the lowest effective HRT dose while minimizing unpleasant side effects and risks.

If you decide to try HRT, it can  be taken via oral drugs or by  transdermal preparations (patches). If you're taking estrogen, and have not had a hysterectomy, you must also take progestin, which prevents the production of abnormal and potentially cancerous cells in the uterus. Follow the specific directions for taking estrogen and progestin, even to the best time of day to  take each.

You may hear about alternative or "natural" treatments for menopausal symptoms. These include ginseng and other supplements. While popular among some women,  none of these products have yet undergone any well-controlled  clinical studies to determine their safety and efficacy. You may also come across advocates of eating foods made from soy, particularly tofu, as an alternative to HRT.

Some medical experts agree that  a diet rich in soy foods may be the primary reason why hot flashes and other menopausal symptoms are so infrequent in Japanese women. Researchers are currently investigating whether soy foods can ease menopausal symptoms  in western women.

The best advice is to know the  facts on HRT, discuss them with your physician and if you choose treatment, to be patient. It can take a while to find the method and dosage most appropriate for you.