Numerous studies have been done on the other beneficial effects
of ERT/HRT, but the results are less clear. Many long-term studies
have suggested that ERT helps to prevent heart disease, although
recent studies have been conflicting.
Promising new research has also suggested that ERT may help prevent
Alzheimer's disease or decrease the risk of colon cancer, although
these results are too preliminary to regard seriously.
ERT has been shown to improve irritating bladder symptoms (frequent
urination, urinary urgency and burning) that are often associated
with urinary incontinence, but the amount of incontinence or urinary
leaking does not appear to improve with estrogen treatment.
Potential risks
ERT (when given by itself) can cause increased growth of the uterine
lining (endometrium) and endometrial cancer However, when progesterone
is added to the estrogen therapy (HRT), that risk disappears. Therefore,
women who have not had their uterus removed should be treated with
both estrogen and progesterone.
Some studies show that ERT and HRT are associated with a small increased
risk for breast cancer but this risk seems to be limited to women
who take ERT or HRT for more than 5 years. Other studies have not
found this increased breast cancer risk. However, it is usually
recommended that women who are at a very high risk for developing
breast cancer, or treated for breast cancer in the past, should
not take ERT or HRT.
ERT or HRT use include an increase in gall bladder disease and a
small increased risk for venous blood clots, such as deep venous
thrombosis (blood clots in the legs).
There are now many ongoing research studies investigating the effects
of menopause. The results of these studies may help physicians advise
their patients on how to effectively and safely manage menopause.
Until more is known about ERT and HRT, women should weigh the benefits
and the possible risks against the symptoms being experienced. Thorough
discussion with a physician is recommended.
To reduce the risks of estrogen replacement therapy and still gain
the benefits of the treatment, physicians may recommend:
|
"Adding progesterone to the estrogen (HRT)" |
|
"Using a lower dose of estrogen or a different estrogen
preparation (for instance a vaginal cream rather than a pill)" |
|
"Having frequent and regular pelvic exams and Pap smear
to detect problems as early as possible" |
|
"Having frequent and regular physical exams, including
breast exams and mammograms" |
Side effects of estrogen replacement are generally rare but may
include:
|
" Vaginal bleeding " |
|
" Breast tenderness " |
|
" Nausea " |
|
" Abdominal bloating " |
|
" Uterine cramps " |
Although menopause is a difficult period for some, most women will
experience menopause without long-term problems. Many women report
an increase in energy, more self-confidence, and a better attitude.
|