For many women, ditching the pill and other contraceptives is an upside of aging. But as they enter their late 40s and early 50s, another hormone dilemma looms large: Is it worth taking synthetic estrogen and progesterone to reduce menopause-induced mood changes, hot flashes and night sweats? Or do the benefits of hormone therapy (HT) pale next to the risks?
The answer is not black and white. Whether hormone therapy is a good choice depends on a woman's age, health history and the severity of her menopause symptoms, which can range from mildly annoying to aggravating enough to interfere with daily life. To help women make informed decisions, HealthLink BC has created an online tool called "Menopause: Should I Use Hormone Therapy (HT)?"
It includes up-to-date facts compiled by a team of Canadian doctors, internists and geriatricians. Even better, it breaks down the "should-I-or-shouldn't-I" conundrum into six sections that encourage women to learn the facts, compare their options and consider how they feel about using hormone therapy.
It is hardly a trivial decision. Since 2002, several major studies have linked HT to higher rates of breast cancer, heart disease, ovarian cancer, blood clots and dementia; while hormone therapy was once routine for women in midlife, the number of women taking these medications has fallen by about two-thirds over the past decade and a half.
Nevertheless, findings from the same long-term studies suggest that HT may help prevent bone loss and possibly colon cancer. In women with premature menopause (before age 45), hormone therapy may reduce the risk of osteoporosis, coronary heart disease, Parkinsonism and mood disorders. And there's no doubt that these medications can take the edge off symptoms such as night sweats, hot flashes and vaginal dryness.
Some websites suggest the fears about HT are overblown – despite the well-documented health risks – whereas HealthLink BC points out alternatives to medication. Dietary soy, supplements such as black cohosh and breathing exercises may help relieve hot flashes. Certain antidepressants may lower the number of hot flashes, and vaginal creams can help restore moisture.
The government-funded tool lays out the pros and cons (including the tempting fact that HT helps preserve skin elasticity) but still takes a stand. "The health risks linked to HT are not high for most women," it states. "But on average, these small risks outweigh the small benefits of [hormone therapy]."