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 Diet Metabolism
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 Initiative 2002
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 Initiative 2002
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 Endometrial cancer Cardiovascular disease
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 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?