The Latest on HRT

Women who are approaching the menopause often experience uncomfortable symptoms such as hot flushes, night sweating, palpations and depression. These arise because of the changing levels of hormones as the ovaries start to wind down production of eggs. This perimenopause precedes the actual menopause, the point at which a woman’s ovulation and periods cease completely.

Women can enter the perimenopause as early as 40 or as late as the late 50s but the average age is 45 to 55. In the last few decades, hormone replacement therapy has been developed but its use has been associated with an increased risk of breast cancer and this has led to worries amongst women. While coping with the stresses and strains of everyday life when experiencing the symptoms of the menopause over several years can be difficult, no woman wants to increase her risk of breast cancer.

Latest Research Findings on HRT

One of the most recent studies on the use of HRT using modern treatments is the WISDOM study, which followed almost 6000 women between the ages of 50 and 69. The women were from Australia, New Zealand and the UK and were followed for several years as they took hormone replacement therapy. Three in every four women found that the treatment reduced the annoying symptoms and after a year, they no longer were bothered by night sweats or hot flushes. Women reported that their sleep was less disturbed and they were more able to enjoy their sex lives as the treatment also helped with vaginal dryness.

The study concluded that the benefits of hormone replacement therapy are definitely greater than the risks in taking the treatment, even for several years. Another trial, the Women’s Health Initiative, has shown that HRT that only contains oestrogen and not progesterone, does not increase the risk of breast cancer at all. The risk is only very slightly increased in women taking a combined HRT medication – and that only occurs with long term use, for seven years at least.

Tailored HRT

The studies all agree that the best results and the lowest risks with HRT are achieved when therapy is individualised to the woman concerned. Many GPs advise that the first few months of HRT should start at the lowest possible dose of hormones; if this does not ease symptoms, the dose can be increased to a level that does make the woman feel better. The dose that is suitable will differ from woman to woman, and will depend on the severity of the symptoms she is experiencing.

New Formulations of HRT

Researchers have recently announced that a new way of delivery hormone replacement therapy could be even safer than the most recently developed tablet forms. HRT could soon be available in a nasal spray that is used just once a day to deliver the hormone oestrogen. This works in a different way to tablets, which release small amounts of the hormone during 24 hours, producing a steady amount in the blood as the day goes on. The nasal spray contains less oestrogen overall but delivers it to the nasal mucosa in just one hit. This switches on the oestrogen receptors in the body that stay on even though the blood level of oestrogen then falls until the next spray.

The lower overall dose and the lower level of oestrogen circulating in the blood for most of the day would reduce the side effects and cancer risks that, although small, have been associated with hormone replacement therapy. The new formulation still has the protective effects against developing cardiovascular disease and osteoporosis.