Menopause 101
(continued)

Approved indications for ERT:

1. To reduce moderate or severe menopausal symptoms.
2. To treat vulval and vaginal atrophy associated with menopause. This can cause itching, burning, dryness in or around the vagina, painful intercourse, recurrent urinary tract infections, or urinary incontinence (leaking urine).
3. To treat certain conditions in which a young woman's ovaries do not produce enough estrogen naturally.
4. To treat certain types of abnormal vaginal bleeding due to hormonal imbalances.
5. To prevent and treat osteoporosis.
6. To treat certain cancers (in men and women).
   
   

Contraindications to ERT:

Estrogen has certain contraindications (reasons it cannot be taken), however, so it cannot be given to all patients with menopause. Your doctor will advise you as to alternative treatments if you are one of those patients.

1. Pregnancy.
2. Undiagnosed vaginal bleeding.
3. Treatment of certain cancers.
4. History of deep vein thromboses.
5. Breastfeeding.
   
   

Common side effects of HRT:

1. Return of periods
2. Irregular vaginal bleeding/spotting
3. Headache
4. Nausea
5. Breast tenderness
6. Bloating (progesterone)
7. Weight gain (progesterone)
8. May exacerbate depression (progesterone)
9. Enlargement of uterine fibroids
10. Exacerbation of endometriosis
11. Fluid retention (may exacerbate asthma, epilepsy, migraine, heart disease, kidney disease)
12. Spotty darkening of the skin
    
    

Taking HRT may also increase your risk of developing asthma according to the Harvard Nurses' Health Study (2000). This study has followed 121,701 women since 1976. It found an unusually high number of cases of adult-onset asthma among postmenopausal women currently taking estrogen and progesterone, as well as past users. The study also concluded that HRT did not increase the risk of chronic obstructive pulmonary disease (COPD) as had been speculated in the past.

Serious potential risks of ERT:

1. Abnormal blood clotting (may increase risk of stroke, pulmonary emboli, or deep vein thromboses).
2. Endometrial hyperplasia
3. Endometrial cancer
4. Increased risk of gall bladder disease
5. Small increased risk of breast cancer (26%)
   
   

Other benefits of HRT:

1. Estrogen alone may decrease a patient's risk of heart disease according to observational data. Estrogen lowers total cholesterol, lowers LDL, and raises HDL (the "good" cholesterol). However, the WHI showed that use of combination HRT may increase a woman's risk of heart disease by 22%.
2. Decreases the risk of osteoporotic hip fractures by 33%.
3. Decreased risk of Alzheimer's disease by nearly 50%.
4. Decreased risk of dementia.
5. Improved memory.
6. Decreased risk of Parkinson's disease.
7. A decreased risk of colorectal cancer by 37%.
   
8. Decreased risk of macular degeneration and cataracts.
9. Decreased risk of insulin resistance (leading to diabetes).
10. Decreased risk of colon cancer by 34%.