Estrogen replacement therapy refers to the replacement of the hormone estrogen when the ovaries no longer are able to produce it. While providing relief from menopausal symptoms such as hot flashes, night sweats, and vaginal dryness, estrogen replacement therapy may also include the use of hormones called progestins. When a woman goes through menopause, either natural or surgical, her ovaries stop producing adequate amounts of estrogen. Surgical menopause refers to the removal of the ovaries.
Generally, estrogen replacement therapy no longer is recommended for long-term use. Women taking estrogen replacement therapy for short-term relief of symptoms from menopause, however, may garner some protection from osteoporosis, heart disease, and colorectal cancer. Estrogen replacement therapy may prevent bone loss that could occur after menopause, thereby decreasing the risk of bone fracture.
Typical mild side effects that can occur during treatment with estrogen replacement therapy include, but are not limited to, headaches, nausea, mild vaginal bleeding, and breast pain. More ominous estrogen replacement therapy side effects may include blood clots, uterine cancer, breast cancer, heart disease, and stroke. Certain gynecological cancers can be fueled by estrogen, such as breast cancer and uterine cancer.
Usually, estrogen replacement therapy is prescribed as a combination of hormones that include not only estrogen, but progesterone. Long-term estrogen use without progesterone may increase the risk of endometrial or uterine cancer. Progesterone typically counteracts the risk of uterine cancer. Hormone replacement therapy may be delivered via pills, patches, creams, or vaginal preparations. Generally, pills and patches are reserved to ease hot flashes, and vaginal preparations are used to treat vaginal dryness.
Women who are receiving hormone replacement therapy usually undergo a physical examination every year. During the physical examination, the doctor may perform a breast exam or order a mammogram. Estrogen typically causes breast tissue to become denser, which may cause breast lumpiness. Lumpy or cystic breasts may make it more difficult for a woman to examine her breasts; therefore, she should receive regular mammograms. A pap smear and pelvic examination may also be performed to check for abnormalities.
Natural alternatives to estrogen replacement may include the incorporation of soy products into the diet. Soy contains isoflavones, or plant estrogens, that mimic the effects of estrogen in the human body. Natural soy products include soy milk, tofu, and soybeans. Although soy products may help alleviate some menopausal symptoms in certain patients, they may not be effective for all patients.
Although hormone replacement therapy carries risks and side effects, it typically is very effective in relieving severe menopausal symptoms that may be disruptive to the life of a patient. Typically, hormonal therapy temporarily is used only until a woman is past menopause. During treatment, the physician may change or experiment with different estrogen treatments to find the most effective method.