Gynaecology

The Science of Women

Homone Replacement Therapy


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Hormonal Replacement Therapy (HRT) is taking hormones to relieve the symptoms of menopause. HRT is very effective in reducing hot flushes, mood swings and dryness of the genital tract. It also reduces the risk of osteoporosis, fractures and certain cancers.

HRT has been used for many years with an understanding that its benefits come with a small risk of breast cancer and venous thromboembolism. Each woman's risks for cancer can vary depending on her family history, her health and lifestyle. Hence it is important that every women discuss with their specialist, the actual risk and benefits of HRT for herself, so that an individualized management can be tailored.

 

HRT & WHI STUDY

In July 2002, the Women's Health Initiative (WHI) — a large clinical trial — reported the risk among 10,000 women on HRT for 5 - 6 years as:-

❖ 38 women as compared to 30 who did not take HRT, developed breast cancer
❖ 37 women as compared to 30 who did not take HRT, developed heart attacks
❖ 29 women as compared to 21 who did not take HRT, developed strokes
❖ 10 women as compared to 16 who did not take HRT, developed colon cancer
❖ 10 women as compared to 15 who did not take HRT, developed hip fractures

Hence, HRT increases the risk of breast cancer from 0.30% to 0.38%, the risk of heart attacks from 0.30% to 0.37% and the risk of strokes from 0.21% to 0.29%.

These are the ‘slight’ increases in health risk associated with HRT that all gynaecologists have been advising, even before the WHI trial was ever conducted.

A further analysis of the Women’s Health Initiative reveals the average age of women starting HRT was 63 years old (with age range of 50-79 years). Hence there is some uncertainty as to whether the increased health risks applies to women starting HRT at the menopause age of 51 years old. In fact, the WHI data suggests there is a reduction in heart disease if HRT is started at a younger age of 50 to 59 years old.

The menopause period can be a trying period of hormonal change. Till date, HRT remains the most effective treatment for disturbing hot flushes and other menopausal symptoms. Each woman's experience with menopause is unique. Review your personal risks and benefits of HRT with your doctor on a regular basis to make sure you have the best treatment option.