HRT
is not without its risks, cautions Dr. Walsh. The greatest concern
is whether taking HRT will increase the risk if uterine or breast
cancer.
Of
postmenopausal women not taking HRT, one in 1,000 will develop uterine cancer,
according to studies. For women who take estrogen alone,
that risk increases between two and ten times , depending on how
much estrogen is in the formulation they take and how long they
take it.
Studies
indicate, however, that when protesting is taken with estrogen, the resk
of uterine cancer is lower than when estrogen s taken
HRT
Options: Choosing The Therapy That's Right For You
Not
all hormone replace therapy (HRT) prescriptions are the same.
There are different timetables for taking the formulates, which,
can cone as a patch or pill.
In
one type of HRT, called sequential therapy, estrogen is taken every
day for two weeks. Then , on the 15th day protesting is
taken as will, Both estrogen and protesting are continued
from day 15 through day 25, and then both are withdrawn. It's at
this time that menstrual-like bleeding begins.
Estrogen
creams are often used by women who experience vaginal
dryness. The cream is inserted with an applicator directly into
the vagina, where it works to replenish vaginal tissue. In
the beginning, vaginal estrogen cream is used three to four
times a week, until vaginal symptoms imp toms improve. Then it's
used less frequently.
Estrogen
patches are often the choice of women who want to take HRT but
can't take estrogen orally because of a small bandage and is worn
on the lower abdomen. the estrogen is absorbed through the
skin and Then released directly into the bloodstream in
timed sequences.
Estrogen
pills are taken by mouth, according to the regimen set by your
doctor. Premarin is the most commonly used pill. It's
a natural form of estrogen mare's estrogen Whereas some other estrogen
pills are synthetic.
How
effective HRT is in fighting heart disease depends on which type
of estrogen you use, according to Brian Walsh, M.D., director of
the Menopause clinic at Brigham and Women's Hospital in Boston.
Estrogen creams and the patch are not as effective as pills . With
the pill, estrogen passes through the digestive tract and
liver, where it exerts its impact on cholesterol. With the patch
and cream, however estrogen goes directly into
the bloodstream, and the effect on cholesterol is
diminished.
|
By
itself. It a ten year study of 398 women taking both hormones, none 0f there
women who took protesting for at least 10 days out of 25 developed
uterine cancer Whether w0men who take HRT are lower risk for uterine
cancer than women who don't take any hormones has not been conclusively
proven, but based on preliminary studies, doctors suspect that the risk
may be lower by an estimated 30 to 40 percent.
If
a woman decides to take only estrogen, she can be monitored for uterine
cancer by her doctor.
Breast
cancer is a concern for women on HRT, Estrogen promotes cancer growth in
lab animals, so there's reason to suspect that giving women
estrogen might stimulate breast cancer. While research on breast cancer
risk from HRT has yielded no definite conclusion, a study conducted at
the centers for Disease Control and prevention in Atlanta determined
that a woman's may be relative to how long she's on the therapy.
women who did not take HRT or took it for less than 5 year.
Women
who take HRT are also at risk for gallstones, particularly during
the first year of therapy, says Dr. Walsh. Also if you've had cancer
of the breast or uterus, have active liver disease or have had major
problems with blood clots, HRT is not usually recommended.
A
Pre-menopause " To -Do" List
Menopause
may bring some physical changes, but thefre arr some steps you can take
now to help you get throuth it, Here are some suggestions.
Get
active: Do some form of weight bearing aerobic exercise for 30 minutes
at least three times a week, and more if possible, Weight bearing
bone density. Aerobic exercise, the kind that gets your
heart rate up continuously for at least 20 to 30 minutes, will
also help keep your cholesterol level down and boost your feeling of
well -being. Dr. Walsh says.
Eat
less fat: Watch your fat intake : 25 percent or less of the
calories eat should come fro fat experts asy .Eating diet low in saturate
fats will help bring your cholesterol level down.
Kick
the butts : Smoking can worsen any menopausal symptoms you have,
Dr, "Wash says, Smoking not only brings on menopause sooner, it
also reduces the small amount of estrogen women do have after
menopause. In addition to Making you feel better at menopause, Quitting
the cigarette habit will also be better for your bone health. you'll
have more estrogen available to maintain your bone
strength.
Consume
calcium: Get enough calcium to keep your boshes strong and healthy
. After age 35, women begin to lose about I percent of their bone mass
per year. The Daily Value for calcium for premenopausal women is 1,000 milligrams,
but some doctors recommend getting between 1,000 and 1,200 milligrams.
An eight ounce glass of I percent low fat milk and one cup of low
fat yogurt with fruit contain about 300 milligrams each. Three ounces of
canned sockeye sal on, with bines, contains about 203 milligrams, and a
half cup of tofu contains about 258 milligrams.
Calcium
supplements are another option. When deciding how many supplements to
take, read the label to see how much " element of milligrams your
body will actually absorb, take the supplements with food ad a
glass of water to help your body absorb thm easily and
efficiently, Says Kendra kaye, M.D. clinical assistant professor
of medicine at the University of Pennsylvania School of Medicine
2nd attending physician at Graduate Hospital,, both in Philadelphia.
Watch
your cholesterol : Ask your doctor to check your cholesterol levels to
make sure you are in the healthy range, says Dr, Walsh. She should
measure the ratio of your total cholesterol to your good cholesterol or
HDL. A total cholesterol/HDL cholesterol ratio between 3.5 and 6.9 means
you are at moderate risk, and a ratio over 7.0 means you are at
high risk. Menopause can cause your ratio to go upm, because levels of
LDL ( Cholesterol) go up and levels of HDL good cholesterol ) go
down.
Monitor
yours symptoms: See your doctor if you have PMS and yours symptoms
are getting worse: you may have begun menopause says Dr. Klutznick. Your
Doctor can perform a follicle stimulating hormone test to determine
whether that is the case .
Talk
to Mom : It the uncertainty of menopause weighs on your mind, told
you your mother about it. It's not uncommon for women
to follow the same pattern as their mothers, says Dr, Walsh
especially if they have a similar health history .
......
And to your spouse: Share information you learn about menopause with
your husband, says Dr, Klutznick. One way to do that is to
ask him to read a book or two on menopause, she says Some
books have chapters just for men.
Savor
the moment : Appreciating where you are in your life and
enjoying it can make the menopausal transition easier, says Borton.
Taking
Charge of the change
Don't
just sit back and worry, or try to ignore it. Here are tips to
help you cope.
Reach
out : " Talk to other women " says Dr. Klutznick. Find
out what symptoms they're having what causes them difficulty and what
they do to cope. A lot of women are doing their own research
and information-gathering and they can bve a tremendous resource for you
she says.
Find
a mentor: Some older women who have been through menopause can
serve as wonderful mentors, says Borton. Find a women 10 to 15
years older who's living a lifestyle you admire and talk to her about
what has meaning in germ life . Make her a role model.
Known
your options : Talk to your doctor about your symptoms and
optins for dealing with them . Deciding to several doctor if you need
to Dr. Klutznick says, until you find one you are comfortable with
and who is willing to respect what you want to do to manage your
menopause.
Stay
connected : " Women need to have a community of other women,
" Says Dr. Klutznick. This can help you feel connected productive
during this transitional time she says. So join a book club
or take art lessons or a course that stimulates your intellect she says.
Expect
sexual changes: some women find that sex is not as passionate but
becomes more affectionate. and this can be fine, since their mate's
testosterone levels may be dropping as will, lowering his sex drive.
Some women also find that certain places on the body that used to
be highly sensitive are less so, and that other places that
were not sensitive now are, says Dr. Klutznick.
Explore
sexual options : Try to stay sexually active, doctors say. Not having
sex can cause your vagina to change in size and elasticity, which
can make sex painful. communicate to your partner the changes you
are feeling and explore new and different the changes you are
feeling and explore new and different ways to have sex that may be more
comfortable.
You
may take longer to lubricate than you used to. Besides allowing yourself
more time, you can also use water based vaginal lubricants. Try
K-Y Jelly or Replens, which are available in drugstores.
If
you do not have a partner, masturbation helps promote circulation and
moistness in the vagina, helping it to Maintain its size and elasticity,
says Dr. Klutznick.
Consider
herbal remedies: Black cohosh, blue choosh, serape rilla wild yam root
and dong quai are among some of the herbs doctors often recommend to
alleviate menopausal symptoms. These herbs contain phytoestrogens, plant
sources of estrogen similar to that produced in the body.
The
levels of phytoestrogens found in these herbs are lower than the doses
of estrogen in HRT and are believed by some doctors to
relieve menopausal symptoms without causing harmful side effects.
Consult with your doctor before using these remedies.