have occasional bleeding similar to a period. Often, changing the form of HT or the dosage can reduce or eliminate such side effects. Talk to your doctor at least once a year to evaluate how you are doing.
The Final Analysis Ultimately, deciding whether to use HT is a highly personal decision, one that depends on the severity of a woman’s menopausal symptoms and her individual health risks. It’s important to weigh the benefits of HT versus the risks so that you can make the best possible decision, for both the short term and the long run. If you’re thinking about trying HT as treatment for menopausal symptoms, schedule a visit to your doctor so you can have a physical exam. Your doctor will also evaluate your personal and family history of cardiovascular disease, blood clots, and breast cancer so that you can make a truly informed decision about how the potential risks and benefits of using HT stack up for you. “If you choose to use HT, start
at the lowest dose that works for you,” explains Kirkpatrick. “The goal is to use HT for the shortest amount of time possible, but what that means will vary from one woman to another.”
{
What About Over-The-Counter Alternatives? Although there’s no shortage of soy-based products and other herbal remedies available on drugstore shelves for the treatment of menopausal symptoms these days, there is a shortage of scientific proof that any of them do much good.
Most studies have not shown them to be effective for hot flashes. Another drawback is that over-the-counter (OTC) herbal products, including soy, black cohosh, red clover, and progesterone creams derived from Mexican yams, are not strictly regulated by the US Food and Drug Administration (FDA), so potency may vary from product to product, or even from batch to batch of the same product. Still, some women who use these products swear
by them. If you decide to use soy or other alternative therapies, be sure to tell your doctor. Some could cause interactions with other medications you are using. Remember: Just because alternative therapies are
referred to as “natural” remedies doesn’t mean they’re without risks or side effects. You should use them with the same care you would when using any OTC or prescription medication. What about bioidentical hormones? These substances, sometimes called “natural” hormones, are chemically similar or identical to hormones your body makes and are often custom-made by specialized pharmacies. Despite claims made by these pharmacies that bioidentical hormones are safer than the ones manufactured by pharmaceutical companies, and just as effective, there is no scientific evidence to support the claims. In fact, these drugs have not undergone rigorous scientific scrutiny for safety or efficacy, and you should assume they have the same risks as hormones approved by the FDA. To learn more, read the FDA’s consumer article “Bioidenticals: Sorting Myths from Facts” at http://www.fda. gov/ForConsumers/ConsumerUpdates/
ucm049311.htm.
Forget About HT If…
There are some women who definitely should not use HT because of their overall health status or their risk factors for various diseases. It’s considered just too risky for them. These include women who: • Have undiagnosed abnormal vaginal bleeding • Have a known or suspected estrogen-dependent cancer (except in appropriately selected patients) • Have active deep vein thrombosis, pulmonary embolism, or a history of these conditions • Have active or recent arterial thromboembolic disease (stroke, heart attack) • Have liver dysfunction or liver disease • Are or may be pregnant • Have hypersensitivity to estrogen therapy preparations
} FALL / WINTER 2011 pause
13
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44