Pros and Cons of Hormone Replacement Therapy and Estrogen Use Alone

Combination hormone replacement therapy and estrogen only replacement therapy are not prescribed as much as they were at one time for the relief of symptoms associated with menopause, due mostly to studies performed by the Women's Health Initiative. Those supporting estrogen replacement therapy have noted that these studies focused on the risks associated with long-term use and that no studies have been completed to date concerning bio-identical hormones. Dietary supplementation with herbs and other plant components may provide a safe and effective alternative to women seeking relief from menopausal symptoms.

Many women have questions about the safety of hormone replacement therapy and estrogen replacement therapy for the prevention of hot flashes, night sweats and other menopausal symptoms. The latest research supporting estrogen replacement at lower doses than were prescribed in the studies performed by the Women's Health Initiative indicates that women may experience a 60-70% reduction in hot flash symptoms. Doctors hope that lower dosages of hormones will be safer, but continue to advise that they should be used for the shortest period of time possible. This may leave many women frustrated, since some menopause related symptoms may appear five or six years before the onset of menopause and may continue for several years after their last period.

Research supporting estrogen like substances found in plants, which are called phytoestrogens or isoflavones, show that dietary supplements containing soy isoflavones can reduce hot flashes by 87.8%. This is about equivalent to the relief experienced by women who use traditional dosages of combination hormone replacement therapy and estrogen only replacement therapy.

The health risks associated with combination hormone replacement therapy and estrogen only replacement therapy include blood clots and stroke. Those supporting estrogen use that is bio-identical believe that since the hormones used are molecularly identical to those produced by the human body, it should be safe. Opponents of hormone replacement therapy and estrogen replacement therapy of any kind believe that menopause is a natural part of a woman's life, and that efforts to keep hormones at a level similar to those of a younger woman will ultimately cause health problems of many kinds.

As with many drugs and other compounds created by pharmaceutical companies, the initial research focuses on relief of symptoms and unwanted side effects. Estrogen replacement therapy first became popular for the relief of menopausal symptoms during the sixties and continued to grow in popularity, until a study published by the New England Journal of Medicine in 1975 reported that women using estrogen were seven times more likely to develop endometrial cancer than women who had never used estrogen. The study showed that the risks increased with continued use and that those women who used estrogen for seven years or more were 14 times more likely to develop endometrial cancer.

In order to reduce the risk of endometrial cancer, pharmaceutical companies added synthetic progestin (similar to the hormone progesterone) commonly referred to as combination hormone replacement therapy and estrogen only replacement was typically reserved for use by women who had undergone a hysterectomy at some time in their past. Those promoting and supporting estrogen and progestin use theorized that estrogen causes the lining of the uterus to build up, but without progesterone, it is not shed, thus adding synthetic progestin would cause the endometrium to be shed and reduce the risk of cancer.

Opponents of hormone replacement therapy and estrogen use quote studies indicating that estrogen can cause breast cancer, heart disease, stroke and other health problems. The majority of experts now advise that if a woman chooses to use HRT, of any type, she should use the lowest dosages for the smallest amount of time possible. For information about alternative solutions for the relief of menopausal symptoms and special nutritional requirements for women, please visit the Menopause and PMS Guide.