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Menopause Treatment News:
Making The HRT Decision - Continued
Making the HRT Decision:
What To Discuss With Your Doctor
While studies are still ongoing, and re-analysis of the original data continues to
shape our opinions, experts say there are a few lessons learned thus far that are
not likely to change.
Among them: That hormone replacement therapy is not a panacea for disease prevention –
even in situations where it was found to be helpful, such as reduction in hip fractures.
Moreover, if hormones replacement therapy must be used to quell menopause symptoms,
the lowest possible dose for the shortest possible duration is now the standard of care.
Perhaps more importantly, today it is not so much a matter of who will benefit from HRT, but the importance of treating every woman individually, with decisions about hormone use made strictly on a case-by-case basis.
"Gone forever are the days when every doctor routinely prescribed HRT for every woman over 50 – today, the decision to go on hormone therapy, even short term, must take into consideration a host of individual health and lifestyle factors," says Smith.
Among the most important things to discuss with your doctor, says Smith, is your personal and family history of heart disease, stroke, blood clots, breast cancer and breast disease, and your reproductive history. Also important: Personal lifestyle choices such as smoking, alcohol use, diet, and your current weight and blood pressure.
Says Smith: "When there are other risk factors for disease in a woman's life, the risk profile of HRT can change, which is why individualized care is so critical."
Stuenkel agrees: "I think one of the most valuable lessons to come out WHI is that every woman needs – and deserves to have - individualized care, not just for menopause symptoms, but for all health concerns."
And that, she says, is a lesson we should not soon forget.
Sources: Steven Goldstein, MD, professor of medicine, NYU Medical Center, New York City, board member, North American Menopause Society; Cynthia Stuenkel, MD, professor of medicine, division of endocrinology and metabolism, University of California at San Diego, board member, North American Menopause Society; Nieca Goldberg, MD, associate professor, and medical director of the NYU Women's Heart Program at NYU Medical Center; JoAnn Manson, MD, PhD, DrPH, chief of preventive medicine, Brigham and Women's Hospital, and professor of medicine and women's health, Harvard Medical School, Boston; Manson JE, New England Journal of Medicine, 2007;356:2591-2602; Vickers, M.R. British Medical Journal, Online First edition, July 11, 2007; Rossouw, J, JAMA. 2007; 297:1465-1477'; Chen, W, Archives of Internal Medicine, Vol. 166 No. 9, May 8, 2006
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