Why are doctors against hormone replacement therapy?

Combined hormone therapy may increase the risk of developing breast cancer, but most studies show that the increase is small (less than 1 in 1000). In the United States, last year, estrogen and progestogen formulations helped more than 6 million women who had symptoms such as hot flashes, sleep disorders and irritability. If you have menopausal symptoms that are affecting your quality of life, you may wonder if hormone therapy is an option for you. In addition to research on the effects of low-dose hormone therapy, recent studies have also established that delivering hormones through the skin through a small patch, called transdermal administration, reduces the risk of serious health problems, such as the formation of blood clots.

Hormone replacement therapy (HRT) helps treat menopausal symptoms, such as vaginal dryness and hot flashes. You should discuss the risks and benefits of hormone therapy with your healthcare provider to determine if it's right for you. In addition to reducing symptoms, people who receive hormone therapy often experience a better quality of life, better general health, and better bone health when taking the medication for less than five years. It's important to make the decision to take hormone therapy after talking with your healthcare provider. Postmenopausal women who take combined estrogen-progestin menopausal hormone therapy for at least five years double their annual risk of breast cancer, according to new analyses of a major study that clearly establishes a link between hormone use and breast cancer, researchers said.

In 2002, a large placebo-controlled clinical trial conducted by the Women's Health Initiative testing oral estrogen plus progestin therapy with higher doses of estrogen and progestin was discontinued due to the increased incidence of breast cancer and cardiovascular disease in women taking the hormones. If you're considering hormone therapy, it's important to learn everything you can from your healthcare provider. Stafford and his colleagues also expected that, for women who needed treatment for menopausal symptoms, doctors would start prescribing hormone therapy more often during or just after menopause. When hormone replacement therapy is used for more than five years, the risks of blood clots, stroke, and breast cancer (specifically when using drugs that contain progesterone) may increase as you age and the longer you take the medication.

Symptoms that may or may not respond to hormone therapy include mood, joint pain, and lack of concentration and memory, commonly referred to as “mental confusion.” After the release of those initial results, the number of women who were prescribed menopausal hormone therapy at higher doses dropped dramatically and fell by 47 percent between 2001 and 2004, according to the Stanford study. Despite recent encouraging findings, many doctors are still reluctant to prescribe hormone replacement therapy, said Manson, head of the preventive medicine division at Brigham and Women's Hospital and one of the principal researchers of the WHI study.