Hormone Replacement

Therapy (HRT)
Jenn Maddock and
Lana Garrett
Health 3500

What is Menopause?
Cessation of menstruation as a result of the aging process
of or surgical removal of the ovaries; change from
fertility to infertility.
Physiological changes that take place within women
between the ages of 30 to 60.
Hormone levels change in female body; practically the
production of estrogen.
Perimenopause and menopause can last 10 plus years.
Menopause itself begins 12 months after a womans final
period.

Symptoms of
Perimenopause/Menopause
Cycles become irregular
Erratic or heavy bleeding
Decrease in sexual response
Irritability/Mood Swings
Fatigue
Forgetfulness

Symptoms of
Perimenopause/Menopause
Headache
Hot flashes
Night sweats
Vaginal dryness
Dry skin
Bone loss
Urinary incontinence

Hormone Replacement Therapy

Supplemental hormones: Estrogen, progesterone,
and testosterone.
Estrogen and progesterone can be made from
plants of from synthetic chemicals.
Delivery options: pills, patches, creams, inserted
into vagina by means of creams, tablets or ring,
placed under skin by implants or by injection;
future: nasal spray.

Benefits of HRT
Maintains thickness and vascularity of
vaginal and urethral tissue for comfort and
lubrication during sexual interaction.
Reduces hot flashes and sleep disturbances
from night sweats.
Protects against osteoporosis and resultant
fractures, particularly of the hip.
Reduces risk of colon cancer

Media Reports of HRT

Media reports: Hazard Ratio- compares the difference
between numbers of people in each treatment condition
who experienced the health problem or benefit.
Example: The Scientists found a 29% increase
in strokes, and a 26% increase in breast cancer.
Absolute Risk- Compares the actual number of people
who experience the problem or benefit.
Example: Womens Health Initiative actual report
was 8% increase in strokes, and 8% increase for breast
cancer.

Estrogen Overload?
Estrogen in the Environment
Cow and Chicken Farms-Range Feed
Plastic
Pesticides

Diet
Metabolism

Reducing the amount of Estrogen

Research looking at lower doses of HTR
Balance of estrogen and progesterone
Progesterone Cream

Stress Relief
Liver Cleansing

Womens Health Initiative

2002
The study
16,608 women
Women ages 50-79
Purpose was to identify risks and benefits of

long-term HRT use

Stopped prematurely because of findings

Womens Health Initiative

2002
Results
26 percent increase of invasive breast cancer
29 percent increased risk of death from

coronary heart disease

41 percent increased risk of stroke
200 percent increased risk of blood clots
Limitations to the study

Risks of HRT
Breast cancer
In 2003 there was 14,000 less cases of breast cancer

possibly due to the decrease in women taking HRT

If a woman is diagnosed with breast cancer while
taking HRT, she is advised to stop immediately.

Endometrial cancer
Cardiovascular disease
Stroke
Blood clots

Side Effects of HRT

Weight gain
Bloating
Breast tenderness
Irregular bleeding
Some do not take HRT for fear of cancer
Some physicians recommend a
discontinuation of HRT

Alternative Therapies
One study indicated 68 percent of women
have tried alternative therapies and 62
percent were satisfied with the results.
Diet and Exercise are the most common.

Alternative Therapies (Diet)

Soy isoflavones in soy products
Relieves a number of symptoms, including hot flashes,

night sweats, fatigue and vaginal dryness

Soy has also been shown to assist the body in
absorbing and retaining calcium, suppress bone loss,
lower LDL cholesterol and decrease blood clotting
Recommended daily amount is 25 grams of soy
protein and 30-50 mg of isoflavones as a starting
amount and could gradually increase to two to three
times that amount
Seen to reduce symptoms in 4 out of 10 women

Alternative Therapies (Diet)

Black Cohosh
Has been seen to reduce hot flashes
Potential for liver damage and shouldnt take

more than 6 months

Calcium, magnesium and vitamins D & E

Magnesium promotes bone density
RDA is 600 mg, although most Americans

only consume 300 mg

Alternative Therapies
Exercise
A study in Sweden showed that out of 1,323 women,

15 percent sedentary women demonstrated hot flash

symptoms compared to only five percent of the
physically active subjects
Weight bearing exercises and strength training
strengthens bones and muscles, enhances self-esteem
and creates a positive outlook, promotes sleep and
increases levels of neurotransmitters in the brain
Serotonin (calming effect), endorphins (pain killers), and
dopamine (alertness and concentration).

Alternative Therapies
Smoking cessation
Reduces risk for pretty much everything!

Avoiding spicy foods for those who get heartburn

Can reduce severity and frequency of hot flashes

Limiting or eliminating caffeine

Promotes sleep

Relaxation methods
Helps with mood swings/irritability

Alternative Therapies
Acupuncture
Reflexology
Controlling weight and avoiding weight
gain
Preparing for hot weather by wearing
layers of clothing and bringing a small fan

Conclusion
Controversial subject
Limited extensive scientific research
Limitations on the studies conducted
HRT or not?
History of breast cancer
Presence of other risk factors

THE END

Any Questions?