How would the advantages and disadvantages of HRT compare for me?

This is the key question that applies when considering HRT or, for that matter, any other medical or surgical treatment. You need to weigh up the potential advantages and disadvantages (Figure 28.2 andChapter 27).

Advantages: 

 

Hormone replacement therapy is indicated to treat symptoms that are attributable to oestrogen deficiency.

  • We know that HRT reduces hot flushes and night sweats ( 9).
  • HRT may overcome local problems including vaginal discomfort and pain during intercourse ( 2).
  • Some bladder problems may be reduced ( 11).
  • HRT may improve menopause-related depression ( Q 27.1) and mental ability ( Q 27.2).

 

Reduce long-term morbidity (poor health).

  • Heart disease ( Q 27.3) is no longer thought to be reduced
  • Osteoporosis ( Q 27.9)
  • Alzheimer's disease ( Q 27.2) may be less common in those who have taken HRT.
  • Reduces early mortality (death) that might arise as a rise of postmenopausal oestrogen deficiency ( Q 27.25).
  • There is an overall reduced risk of cancer ( Q 27.25).

Disadvantages:

No treatment is without potential side effects (20)

There can be little doubt that the greatest concern for women considering HRT is breast cancer. The additional risk is very low (Q 27.15).

Similarly, the other potential risk of thrombosis is extremely uncommon (Q 27.22).

The majority of gynaecologists and physicians have believed that for most women the advantages of HRT significantly outweighed the disadvantages. Recent evidence, however, has shown that the benefits in relationship to coronary heart disease are no longer valid. Ultimately it is for you to evaluate the available information and to decide for yourself whether you feel that HRT is the right choice for you. There can be little harm done in putting HRT to the test for a short time.


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This is the personal website of David A Viniker MD FRCOG, retired Consultant Obstetrician and Gynaecologist - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.

The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.

David Viniker retired from active clinical practice in 2012.
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