Hormone Replacement Therapy (HRT) is the most common treatment used to counter menopausal symptoms. HRT is a treatment where female hormones such as synthetic estrogen or combined estrogen and progesterone are prescribed to increase the hormonal level of women who are in the menopausal stage. The hormones are usually in the form of tablets, skin patches, vaginal preparations, implants and nasal spray.

At the menopausal stage, a woman’s body produces less estrogen and progesterone. Lower amounts of estrogen are the cause of menopausal symptoms. HRT replaces these hormones in the body and help ease these symptoms.

However, the use of HRT is still controversial as the long-term safety and efficacy are yet to be determined.

Although HRT used to be the most common medical treatment, it is not meant for everyone. Women who have suffered from breast cancer or uterine cancer are not advised to use HRT. Those who have blood clotting disorder or liver disorder should also not use HRT. Other than that, HRT is also not meant for women who experience vaginal bleeding (that is not a normal period) or may be pregnant.

HRT Benefits
HRT helps to relieve hot flushes and night sweats, allowing women in the menopausal stage to sleep better. Using HRT also promotes the growth of the vaginal lining; this in turn reduces vaginal dryness and relieves further discomfort such as itching.

These are the short-term benefits of HRT. Unfortunately, no long-term benefits can be supported as many studies ended prematurely as the results illustrated that the risks of HRT outweighs the benefits.

HRT Risks
Even though HRT is able to relieve some of the symptoms of menopause, it may not be the right choice as it increases the likelihood of getting some potentially serious conditions.

A recent Women’s Health Initiative Hormone Trial, designed to assess the risks and benefits of HRT in more than 27,000 women, has shown associations to significant increases in the risk of stroke (41%), heart attack (29%), cardiovascular disease (22%), thrombosis (20%) and breast cancer (26%).

• Heart Disease and Stroke
  

  Heart disease and stroke normally occur due to the build-up of fatty deposits in blood vessels or by the presence of blood clots in the arteries.

  HRT is believed to prevent heart disease as it has favourable effects on fat levels in blood. However, recent studies proved otherwise. Women who used HRT were also found to have a higher chance of suffering from stroke. The study also revealed that HRT may increase the risk of heart disease in the first year of use. Therefore, the use of HRT is not advised as it may increase the occurrence of heart disease and stroke.

• Breast Cancer
  

  The long-term use of HRT may increase the risk of breast cancer. However, it was found that estrogen-only HRT causes a smaller increase in risk of breast cancer when compared to combined HRT. Besides, women who consume combined HRT may suffer breast cancer in which the growth may be of a slightly larger size.

  The risk of breast cancer is noted to increase after the first year of using HRT. The longer HRT is used, the higher the risk of breast cancer. Hence, long-term use of HRT should not be practised. Even so, the risk will eventually start to decline when HRT is stopped. HRT is also not recommended for women who have a history of breast cancer.

• Blood Clots
  

  HRT is found to raise the risk of blood clots (thrombosis). Harmful blood clots restrict bleeding when injured and may be formed in the veins. The veins in the calf are amongst the most common places where blood clots tend to occur. This will cause the legs to be red, swollen and painful. This is known as venous thrombosis (sometimes called deep vein thrombosis or DVT).

  The lungs is another area where blood clots may be present; this is especially so if a woman is of a mature age and has been on long-term HRT. Blood clots that lodge in the lungs pose as an obstruction and may cause breathlessness or sharp pains in the chest. This may lead to collapse or fainting. At times blood clots may cause serious problems and in some cases, it may even be fatal.