Friday, May 23, 2008
Hormone Replacement Therapy (HRT) - The HeaRT of the Matter
I was getting my hair done a couple years ago at my favorite salon, along with five other women 'of an age', when talk turned to the Change. Most of us were loudly proclaiming our favorite natural remedies and fixes. The woman in the chair adjacent to mine finally spoke up apologizing to the roomful of menopausal goddesses for having “caved”, finally starting HRT (Hormone Replacement Therapy)..
“It's just that I couldn't sleep,” she told us shamefacedly. “I couldn't sleep at all. I was so tired I couldn’t function. And nothing else worked.” We all leapt in to assure her that there was no need to feel guilty. The risk-benefit ratio seemed pretty clear to all of us. Underscored for us was that we women need to support one another through this process rather than judge anyone, including ourselves.
But I have to admit that I was feeling pretty smug and blessed that I was coping without HRT. My symptoms were manageable. What’s that thing they say goeth before a fall? Oh yeah, pride. I no longer have a surplus of that. I eventually ended up on low dose HRT myself. And honestly, I wish I’d taken it sooner.
First welcomed as a godsend, now seen as a terrifying, politically incorrect alternative for menopause symptom relief, HRT may actually be neither. In deciding whether we wish to consider HRT as a viable option, we really need to evaluate our personal risk-benefit analysis. In other words we need to list pros and cons, and then weigh those pros and cons in order of importance.
History of breast or other reproductive cancers in your family would cause you to rate your risk higher. Family history of blood clots, stroke, or heart disease also put you at higher risk. If you have or have had any of these conditions yourself, the risk may be too high and you'll want to look elsewhere for help. And if you are a smoker? HRT is not a great idea for you; your risk of heart attack, stroke and other cardiovascular disease spikes.
On the benefit side, if your hot flashes are 30+ per day, so intense that you are nauseous, or your sleep deprivation from insomnia is making you psychotic, then HRT may be a valuable help in the short term. More risk is associated for all women with long term usage of HRT, so taking it to “get over the hump” may be an option. Above all, do not feel guilty if you decide that the herbal, natural route didn't work for you and you need to avail yourself of HRT. Our own Beej-Venus tried herbs and immediately stopped using them because they “gave me a rush”.
If you should decide to consider HRT as an alternative, be sure to stay aware and re-evaluate periodically whether you might be ready to slowly decrease and ultimately discontinue your hormones. Above all, be gentle with yourself and choose what’s right for you. (Next blog entry, we’ll examine briefly both bioidentical and synthetic hormones. Material partially adapted from our upcoming book -to be released very soon. We’ll keep you posted. For the latest, visit our mothership blog at menopausegoddessblog.org)