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A new "position statement" from the North American Menopause Society discusses the benefits and risks of using hormone replacement therapy (HRT), noting that HRT may be safer for younger menopausal women with severe menopausal symptoms. In recent years, women have been bombarded with messages that HRT can cause breast cancer. However, the Society notes that a large government study that has been the focus of many of the warnings about HRT was conducted with older women-average age 63-whereas most women enter menopause between ages 45-55. While the Society did not develop any specific guidelines for HRT use, it argues that little research has been conducted on younger menopausal women. Hormone replacement therapy (HRT) is synthetic estrogen and progesterone (called progestin) designed to "replace" a woman's depleting hormone levels as she nears menopause. Decreased levels of estrogen may cause hot flashes, vaginal dryness, sleep disturbances, or other bothersome menopausal symptoms. HRT helps to relieve these and other effects. Past research has shown that HRT may also help prevent osteoporosis, heart disease, short-term memory loss, depression, and other diseases in post-menopausal women. However, recent research has found that HRT may not provide these benefits and may pose other risks, most notably an increased risk of breast cancer. In July 2002, the National Institutes of Health halted a large study on HRT, called the Women's Health Initiative, because the research showed a slight increase in breast cancer risk. The Menopause Society acknowledges the risks of HRT, but notes that the average age in the study was 63. In a new position statement on hormone replacement therapy, the Society says that the women in most need of HRT to relieve menopausal symptoms are younger. These women are usually between the ages of 45-55, with an average age of 51. The Society does not suggest that younger women needs relief from menopausal symptoms should get relief from HRT. However, it notes that studies show that HRT is extremely effective for relieving these symptoms. About one-third of women have moderate to severe symptoms such as hot flashes that other strategies-such as dressing in layers, avoiding spicy foods, etc.-cannot treat. Most experts argue that HRT may still be appropriate for some women. For women who suffer from severe menopausal symptoms and have a low personal risk of breast cancer, short-term use of HRT may be an appropriate option. A thorough discussion of these issues with a physician is recommended for all women considering or currently taking HRT.
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