Why do doctors not recommend hrt?

However, doctors often recommend medications called bisphosphonates to treat osteoporosis. However, estrogen therapy can help if you can't tolerate it or. In 1998, the Women's Health Initiative (WHI) began, which was the largest randomized study conducted to date and whose objective was to evaluate the effect of hormonal hormone therapy on the most common causes of death and disability in postmenopausal women, such as cardiovascular disease, cancer and osteoporosis. Women with a uterus (16,608 participants) were randomized and received a combination of 0.625 mg of conjugated equine estrogen (CEE) and 2.5 mg of medroxyprogesterone acetate, and women without a uterus (10,739 participants) were randomly assigned and received 0.625 mg of conjugated equine estrogen or a placebo. The first results of the WHI were published in 2002, after an average follow-up period of 5.2 years.

In the group with intact uteruses, there was an increase in the incidence of coronary heart disease and breast cancer, while osteoporosis fractures and colorectal cancer were reduced. In view of these results, it seemed that the risks outweighed the benefits, so the trial was discontinued prematurely. The data was widely disseminated in the media, causing panic among HRT users and forcing doctors to adopt new guidelines on the prescription for HRT. The message was that hormone replacement therapy, without specifying the type and route of administration, was associated with more risks than benefits.

However, no distinction was made between users and their age. Most doctors and scientists agree that HRT, and specifically the estrogen it contains, is good for menopausal symptoms. None of these alternatives (diet, exercise, selective serotonin reuptake inhibitors (antidepressants) or other prescription medications, herbal remedies such as red clover and black cohosh, or “bioidentical” or natural hormones) have been shown to be as effective as hormone replacement therapy in controlling symptoms such as hot flashes. Many women find that hormone replacement therapy transforms their lives.

By replenishing the supply of hormones, HRT reduces menopausal symptoms. It can also protect you from diseases such as osteoporosis. Your doctor can help you determine these risks and benefits to determine if hormone therapy is the right option for you. You and your doctor should consider all of these risks when deciding if hormone therapy might be an option for you.

To determine if hormone therapy is a good treatment option for you, talk to your doctor about your individual symptoms and your health risks. This combination therapy was recommended for women with an intact uterus, which sparked renewed enthusiasm for the treatment of HRT. Hormone therapy is generally not recommended for people with a medical history of breast or uterine cancer, undiagnosed postmenopausal bleeding, active liver disease, heart attack, stroke or diagnosed cardiovascular disease, uncaused blood clots in the legs or lungs, or inherited blood clotting disorders. Following these announcements, regulatory authorities in the United Kingdom issued an urgent safety restriction on HRT, recommending that doctors prescribe the lowest effective dose to alleviate symptoms, use it only as second-line treatment for the prevention of osteoporosis and not use it in asymptomatic postmenopausal women.

As researchers learn more about hormone therapy and other treatments for menopause, recommendations may change. Some doctors, for example, have been reluctant to continue prescribing hormone therapy beyond the five years described as “short-term” in the prescribing guidelines, even when a woman continues to have severe menopausal symptoms and, knowing the possible risks, wishes to continue taking it. The negative results of the study received wide publicity, causing panic among some users and new guidelines for doctors about prescribing hormone therapy.