Menopause
Description
An in-depth report on the treatment of menopause-related symptoms.
Alternative Names
Estrogen; Hormone replacement therapy
Highlights
Hormone Replacement Therapy (HRT) and Breast Cancer
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Estrogen-only hormone therapy does not appear to increase breast cancer risk when used short-term, according to the latest results from the Women’s Health Initiative trial. The 2006 study, published in the
Journal of the American Medical Association
, evaluated women who had a hysterectomy and who took estrogen for an average of 7 years.
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Longer-term use of estrogen may increase breast cancer risk, according to a 2006 study in
Archives of Internal Medicine
. Researchers found a 42% increase in all breast cancers for women who took estrogen for at least 20 years, and a 48% increased risk in hormone-sensitive breast cancer for women who took estrogen for at least 15 years.
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Women who take estrogen need regular mammograms and may require breast biopsies.
Hot Flashes
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Nonhormonal treatments do not work as well as estrogen therapy in relieving hot flash symptoms, concludes a review in the
Journal of the American Medical Association
. Researchers found that antidepressants, clonidine, and gabapentin helped somewhat but not as much as estrogen. Red clover extracts had no benefit, while the results for soy isoflavones were mixed.
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Current guidelines recommend that women take the lowest dose of hormones for the shortest time necessary. Women should stop HRT once symptoms improve.
Menopause and Depression
Women who have no history of depression may experience depression as they transition into menopause, suggests a study in the
Archives of General Psychiatry
. Women who enter perimenopause at a younger age may be at increased risk.
Menopause and Heart Disease
Heart disease risk factors may trigger early menopause, according to a study in the
Journal of the American College of Cardiology
. Women who had heart disease risk factors (such as smoking, high cholesterol, and high blood pressure) were more likely to enter menopause at a younger age than healthier peers.
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Review Date: 6/11/2006
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Reviewed By: Harvey Simon, M.D., Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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