Is hormone replacement therapy a disaster or a boon for menopausal women?

The WHO defines menopause as a cessation of menstrual periods after the age of 40; periods must stop for at least 12 months. In India, 130 million women live beyond the age of menopause, and the average age of menopause is 46.2 years, compared to 51 years in their western counterparts.

Why is menopause so big? Or is it?

Menopause comes with problems like hot flashes, irritability, depression, anxiety, insomnia, weight gain and some genitourinary problems. Repeated urinary infections, vaginal dryness, lack of interest in sex and painful sex due to dryness are some of them.

“The long-term effects of menopause due to low estrogen hormones are osteoporosis (weak bones) leading to fractures, cardiac arrest and Alzheimer’s disease,” says Dr Shelly Singh, Senior Consultant, Obstetrics and Gynaecology, Rosewalk Healthcare and Fortis La Femme.

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In the past, women were conditioned to view these symptoms as inevitable, however debilitating; to bear them as part of the normal aging process. But now empowered women with better life expectancy living hectic and fruitful life are looking for solutions to deal with these issues? Why does he endure? Why not heal?

What are the options for curing post-menopausal symptoms?

“Hormone replacement therapy, non-hormonal therapy, vaginal creams and lubricants, nutritional agents, calcium, vitamin D, and lifestyle changes such as regular exercise, healthy eating, and weight control,” adds Dr. Singh.

Is hormone replacement therapy good? Doesn’t it cause strokes, heart attacks, breast cancer and weight gain?

“These are questions we get asked a lot. HRT took off in the 1960s as a magic cure for menopause symptoms. However, there was a study done in the US called the Women’s Health Initiative (WHI). Women in the 50-70 age group, some well over 10 years past menopause, on only one type of hormone therapy were enrolled in a study whose results were published in 2002. The results showed improvements in osteoporosis and colon cancer, but a clear increase. in the risks of heart disease, stroke and breast cancer,” adds Dr. Singh.

This was widely publicized and by the media and HRT fell into disrepute. Clinicians stopped prescribing the same thing, and women were understandably panicked to even use it for short periods. This fear has persisted to this day, denying menopausal women from addressing so many climacteric issues.

What is the current knowledge and research about HRT?

With newer forms of estrogen and progesterone available with fewer side effects and more studies done, HRT has been shown to be safe in women who are younger than 60 and less than 10 years past menopause. “There is a clear reduction in hot flashes, vaginal dryness, osteoporosis, heart disease and cognitive decline. There is an improvement in sexual appetite and more fruitful relationships. However, one size does not fit all! Each woman must be evaluated, past history reviewed, contraindications ruled out, and treatment personalized. Some women may not be good candidates for HRT,” believes Dr. Singh.

However, for women who are able to receive them, an informed choice is sure to help them live an enriched, empowered, longer and healthier life.

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