Hormone replacement therapy: Houston-area doctor explains benefits, risks for women during menopause

As women age, menopause can lead to a reduced quality of life. From hot flashes to decreased muscle mass, an uptick in depression, anxiety, and sexual dysfunction, symptoms caused by declining estrogen levels can be hard to cope with.

Now, new research on hormone replacement theory (HRT) is shedding new light on the benefits, that doctors say, outweigh the risks.

“There was a lot of fear, the message overwhelmingly was ‘don’t take HRT. You’re gonna get breast cancer,” said Dr. Mary Claire Haver, certified OB/GYN and founder of “The Galveston Diet.” “That data’s been debunked, now we can talk about it logically.”

From oral medications to patches, sprays, gels, or creams. There are myriad ways to deliver estrogen therapy and combination therapy back into the body. New North American Menopause Society guidance says the benefits outweigh the risks. Dr. Haver says the breast cancer risk is minimal.

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“So when we look at the risk of the woman, aged 50-59, follow her for five years. Her breast cancer overall is 23 out of 1000,” she said.

When that woman goes on estrogen therapy, the risk of 23 out of 1000 remains the same. There is no increase.

For women taking estrogen and progesterone, the combination prescribed for women who still have a uterus, the risk rises--but only slightly--to 27 out of 1000.

By contrast, two glasses of wine per day put your cancer risk at 28 out of 1000.

Being overweight or obese pushes your risk to 44 out of 1000.

New research shows the earlier perimenopausal or menopausal women take HRT, the better.

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“The North American Menopause Society has come out strong and said: The benefits definitely outweigh the risks, at least until Age 60 and possibly beyond,” Dr. Haver said. “For example, the American Heart Association came out with a statement, saying women on HRT starting young, it’s a timing issue -- early perimenopausal or early menopause -- actually have a decreased risk of a new development of cardiovascular disease and death. Also, all because mortality death from any cause -- is lower in HRT cohort than women who didn’t take it.”

When it comes to testosterone, Dr. Haver says despite the popularity of pellets it’s not a magic bullet.

“Testosterone is different. It is not anything we consider HRT classically. I do prescribe it for hypo-active sexuality desire disorder. But outside of that, I haven’t seen anything to greatly support its use,” she said.

Pellets are also pretty pricey, and they’re not typically covered by insurance. So Dr. Haver tries to steer her patients toward something affordable with good results. Be sure to discuss all your options with your doctor.

For more information on HRT, and the latest research, click here.