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

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.

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

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

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.

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

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.

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

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

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

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

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

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

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.

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

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

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).

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

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

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

THE END Any Questions?