Do the Benefits of Hormone Therapy Outweigh the Risks?

Thursday 10 December 2020
Hormones

Table of Contents


I. What is Hormone Therapy?

a. Types of Hormone Replacement Therapy

II. What are the Benefits of Hormone Therapy?

a. Symptom Relief

b. Reduced Osteoporosis Risk

c. Other Benefits

III. What are the Risks of Hormone Therapy?

a. Breast Cancer

b. Other Types of Cancer

c. Blood Clots


What is Hormone Therapy?

Hormone replacement therapy (HRT) is a form of treatment that aims to replace natural hormones in the human body. Typically, HRT is used to treat women that have lower levels of estrogen and progesterone due to menopause. Hormone replacement therapy medications may be prescribed to treat the symptoms of menopause itself or postmenopausal conditions such as osteoporosis.

While HRT is typically used for menopausal or postmenopausal women, it can also be used to treat men. When treating men, testosterone (the male hormone) is prescribed. Testosterone is important for building muscle bulk, maintaining bone density, maintaining levels of red blood cells, and for sexual and reproductive functions. [1]

a. Types of Hormone Replacement Therapy

For women, there are two main forms of hormone replacement therapy: systemic hormone therapy and vaginal hormone therapy. Your doctor will decide which form is suitable for you based on the following factors:

  • Severity and range of symptoms
  • Age
  • General health
  • If you have had a hysterectomy

a woman sitting on a couch writing in a book

Systemic hormone therapy involves the hormones being absorbed throughout the entire body. Usually, systemic therapy involves higher doses of estrogen and progesterone and can be used to treat any of the symptoms of menopause. Common systemic medications include Estraderm patches (estradiol), Climara Patches (estradiol), and Estrace (estradiol).

By contrast, vaginal hormone therapy is given to treat vaginal or urinary menopause symptoms. Medications such as Vagifem (estradiol) and Premarin Cream (conjugated estrogens) are usually given in a  lower dose. [2] Keep reading to learn about the risks and benefits of hormone replacement therapy. 

What are the Benefits of Hormone Therapy?

Before starting any form of hormone replacement therapy, your doctor will help you weigh the risks and benefits of the treatment. This can help you to decide whether or not HRT is right for you.

a. Symptom Relief

The key benefit of hormone replacement therapy is to reduce the severity of menopausal symptoms. The most frequent symptoms of menopause include hot flashes, vaginal discomfort, sweating, anxiety, irritability, and more frequent urination. [3]

The frequency and severity of menopausal symptoms can vary greatly between women. While we may think of hot flashes as the most obvious sign of menopause, around a quarter of women do not experience them. Around 15 percent of women experience severe hot flashes that can cause great distress and discomfort. [4] [5]

Usually, symptoms are more severe for women that experience menopause suddenly or for a shorter period of time. Other things that can increase the frequency, duration and severity of symptoms include cancer, having a hysterectomy, and smoking. [4] For women that have severe symptoms, hormone replacement therapy can have a big impact on their quality of life.

b. Reduced Osteoporosis Risk

Osteoporosis is a condition that affects your bone density and affects the strength of your bones. This can result in frequent bone fractures and breaks. In severe cases, something as harmless as coughing or bending over can lead to a fracture. [6]

A doctor looking at an x-ray of a fracture

There are clear links between osteoporosis and menopause. This is due to reduced levels of estrogen in the body. Osteoporosis is typically treated using bisphosphonates. For women that cannot tolerate bisphosphonates, or if this medication is ineffective, then hormone replacement therapy can be beneficial. [2]

c. Other Benefits

Hormone replacement therapy can also reduce your risk of several other conditions. This includes colon cancer, diabetes, joint pain, and tooth loss. Additionally, HRT can help improve women’s mental health and their overall sense of mood and well-being. [7] 

What are the Risks of Hormone Therapy?

Both the North American Menopause Society (NAMS) and the American College of Obstetricians and Gynaecologists (ACOG) believe that the benefits of HRT outweigh the risks for many women. However, this is not the case for all women. It is important to speak to your doctor about the risks of HRT before starting any form of hormone therapy. [8]

A doctor standing smiling in a hall way

a. Breast Cancer

Research has shown that taking a combination of estrogen and progesterone for more than a year increases the risk of developing breast cancer. The longer that both hormones are taken, the higher the risk. Once you stop HRT, the risk starts to decrease. [9]

b. Other Types of Cancer

In addition to breast cancer, hormone replacement therapy may also increase your risk of endometrial and ovarian cancer. The risk of endometrial (womb) cancer can increase when estrogen-only HRT is taken. For this reason, estrogen-only HRT is typically prescribed for women that have had a hysterectomy, so have there is no risk for endometrial cancer. [10] It is believed that hormone replacement therapy may also increase the risk of ovarian cancer. This increased risk is very small and decreases once treatment is completed. [9]

c. Blood Clots

Along with cancer risks, hormone replacement therapy can increase the risk of blood clots when taken as a pill. HRT pills can increase your risk of blood clots by two and four times. Other HRT forms do not pose this risk. Estrogen-only pills may also slightly increase the risk of stroke. [9]

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.