uterine cancer, liver disease, a blood clot, heart disease, high blood pressure, a heart attack, or a stroke. It may also not be a good choice if you have uterine fibroids, since estrogen can make them grow bigger, and thus cause pain and bleeding.
How long should I stay on the therapy?
Discuss this concern with your doctor, who can help you weigh the risks. A Women’s Health Initiative trial reported an increase in heart disease, invasive breast cancer, and blood clots associated with long-term use. In her JAMA editorial, in fact, Harvard physician Suzanne Fletcher urged clinicians to stop prescribing the combined estrogen/progestin pill for long-term use. The WHI study, she wrote, “demonstrates that risks from the drug add up over time.”
What are my alternatives to HRT?
Many bothersome symptoms associated with menopause, including hot flashes and mood swings, frequently get better on their own. One of the best things women can do, according to the National Cancer Institute (NCI), is to adopt a healthy lifestyle — including not smoking, getting regular exercise, and having a good, nutritious diet. This will help lower your risk of bone loss, which increases as you age. You may also want to take calcium and vitamin D supplements.
If you are at risk of heart disease or osteoporosis, and lifestyle changes don’t seem to be working, there are many prescription drugs available to help ward off those conditions. And there are a variety of nonhormonal therapies to treat bladder problems and vaginal dryness associated with menopause.
Unfortunately, few effective alternative treatments exist for menopausal symptoms that are severe. But many women seek relief from hot flashes, mood swings, and other annoying symptoms of menopause through yoga, wearing layers of loose-fitting cotton clothing, and relaxation exercises. You may also try alternative remedies such as foods that contain plant estrogens (including soy products and whole-grain cereal), herbs such as black cohosh, and vitamin E and B complexes, according to the NCI. The safety and effectiveness of these remedies is still being studied, so be sure to discuss your decision with your physician.