This is a unique time in our lives when our hormones are changing from month to month. Even if you are still having regular monthly periods you may still be having symptoms of low or imbalanced hormones. Those symptoms that are most common are night sweats, hot flashes, vaginal dryness, urine loss, diminished sex response or drive. However, there are many other symptoms such as depression, mood swings, joint pain, dry skin, increased facial wrinkling, sleep disturbance, fatigue, itchy skin, hair loss or thinning. Many women want to avoid hormone replacement due to concerns about chronic illness or cancer they perceive might be associated with taking hormone replacement.

Many studies have shown not only improvement in quality of life with woman who take hormone replacement but also health benefits. You need to make an informed decision about how you want to experience menopause. We will be happy to discuss options, benefits and risks at length with you.

As a provider of women’s health care for many years, I understand your frustration and concern over the publicity of the risks of taking hormone replacement therapy. The information has not only been confusing but makes it difficult for offer advice for our patients. One thing is clear: nothing is clear! Over the years hormone replacement has been prescribed in many different forms. One of the most frequently prescribed and studied forms are Premarin and Prempro. Prempro is a combination of both estrogen derived from pregnant mare’s urine and synthetic progesterone in the form of medroxyprogesterone acetate or Provera. There are many other types and forms of both estrogen and progesterone. The much publicized study showing increased risk of stroke, heart attack, blood clots and breast cancer was performed by the National Institutes of Health and started just over 5 years ago. The study recruited 16,608 health volunteers age 50-79 and randomly assigned them to take either Prempro, if the volunteer had a uterus, and placebo or women who had had a hysterectomy to Premarin only or placebo. The study was to take 8 years before completion. The study was halted after 5.2 years when increased risks were shown. It should be emphasized that these risks were small but ethically when a study shows increased risk to any one group it is halted. This is not a drug recall. The Premarin only group study has continued.

• Osteoporosis prevention
• Slightly decreased risk of colon cancer
• Vaginal health, decreasing dryness and painful intercourse
• Better sleep with control of night sweats
• Control of hot flashes
• Control of stress incontinence if related to estrogen deficiency
• Less wrinkling, decreased skin drying by improving loss of collagen in the skin
• Women who take hormones have less weight gain during menopause than women who do not chose to use HRT
• Improved sex drive
• Improved quality of life

• Blood clots if you have had a history of deep vein thrombosis
• Increased risk of stroke if you have had a history of above
• Increased triglycerides (type of blood fat) using transdermal or patches eliminates this risk by bypassing the liver
• Increased risk of breast cancer (see statistics above) in 10+ years of use
• Restarting periods (can be controlled by dosing and different regimens) but for some women this is felt to be a benefit