Hormone Replacement Therapy (HRT)

1. Hormone Replacement Therapy (HRT) Jenn Maddock and Lana Garrett Health 3500

2. 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 woman’s final period.

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

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

5. 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.

6. 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

7. 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: Women’s Health Initiative actual report was 8% increase in strokes, and 8% increase for breast cancer.

8. Estrogen Overload? • Estrogen in the Environment • Cow and Chicken Farms-Range Feed • Plastic • Pesticides • Diet • Metabolism

9. Reducing the amount of Estrogen • Research looking at lower doses of HTR • Balance of estrogen and progesterone • Progesterone Cream • Stress Relief • Liver Cleansing

10. Women’s Health Initiative2002 • 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

11. Women’s Health Initiative2002 • 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

12. 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

13. 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

14. 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.

15. 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

16. Alternative Therapies (Diet) • Black Cohosh • Has been seen to reduce hot flashes • Potential for liver damage and shouldn’t 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

17. 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).

18. 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

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

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

21. THE END Any Questions?