This is because taking estrogen without a progestin can thicken the lining of the uterus, which can increase the risk of endometrial cancer. If you still have a uterus, your healthcare professional will likely prescribe estrogen along with a progestogen, which is a group of drugs similar to progesterone. If your uterus has been removed, you may not need to take a progestogen along with estrogen. Doctors are still prescribing menopausal hormone therapy pills in higher doses, despite clinical evidence that low doses and skin patches work just as well and they pose fewer health risks.
The benefits of hormone replacement therapy (HRT) often outweigh the risks. Recent evidence indicates that the risks of serious side effects from HRT are very low. When hormone replacement therapy is used for more than five years, the risks of blood clots, stroke, and breast cancer (especially when using drugs that contain progesterone) may increase as you age and the longer you take the medication. People over 60 who start hormone replacement therapy have a higher risk of cardiovascular disease and dementia, so they don't usually recommend hormone replacement therapy, as the risks outweigh the benefits.
Even if hormone replacement therapy isn't right for you, there are other treatment options that your healthcare provider may recommend to help treat menopausal symptoms. That said, there are times when healthcare providers don't recommend HRT after evaluating your situation. If you've had a hysterectomy (surgery to remove the uterus), your healthcare provider usually recommends estrogen-only therapy. Perhaps doctors who are familiar with the immediate benefits of higher-dose hormone therapy to alleviate menopausal symptoms are reluctant to change, Tsai said.
As researchers learn more about menopausal hormone therapy and other menopausal treatments, recommendations may change. As for the WHO study, 67.9% stated that the study had no influence on clinical decisions, 28.6% stated that they prescribed hormone therapy more cautiously after the results of the study and only one doctor (3.6%) did not recommend it because of this study. Doctors across the country continue to prescribe hormone therapy pills for menopause at higher doses, despite clinical evidence that low doses and skin patches work just as well and pose fewer health risks. In particular, for menopausal patients, doctors are tasked with sharing medical evidence, including information about the benefits and risks of hormone replacement therapy.
In addition, a minority of women reported that they were ideally against the use of replacement hormones, doctors advised against using HRT and did not use it for fear of side effects. In total, 41.7% of the users said they were satisfied with hormone replacement therapy; 75.0% would recommend the treatment to a friend, while the remaining 25.0% would not, and 16.7% said they were not satisfied with the treatment. Hormonal therapy is not recommended if you are over 60 and haven't had a menstrual period in more 10 years old.
