Hormone Replacement Therapy HRT

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Hormone Replacement Therapy (HRT)

• Jenn Maddock and Lana Garrett
• Health 3500

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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 womans
  final period.

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Symptoms of Perimenopause/Menopause

• Cycles become irregular
• Erratic or heavy bleeding
• Decrease in sexual response
• Irritability/Mood Swings
• Fatigue
• Forgetfulness

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Symptoms of Perimenopause/Menopause

• Headache
• Hot flashes
• Night sweats
• Vaginal dryness
• Dry skin
• Bone loss
• Urinary incontinence

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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.

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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

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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 Womens Health Initiative actual
  report was 8 increase in strokes, and 8
  increase for breast cancer.

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Estrogen Overload?

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

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Reducing the amount of Estrogen

• Research looking at lower doses of HTR
• Balance of estrogen and progesterone
• Progesterone Cream
• Stress Relief
• Liver Cleansing

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Womens Health Initiative2002

• 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

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Womens Health Initiative2002

• 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

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Risks of HRT

• Breast cancer
• 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

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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

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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.

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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

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Alternative Therapies (Diet)

• Black Cohosh
• Has been seen to reduce hot flashes
• Potential for liver damage and shouldnt 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

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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).

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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

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Alternative Therapies

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

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Conclusion

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

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THE END

• Any Questions?