Pros and Cons of HRT: April 27, 2011

H-R-T. Three letters that continue to conjure up controversy. "Hormone replacement therapy remains a serious inigma within all of medicine," says Dr. Edward Grendys, a gynecologic oncologist on the Lee Memorial Health System medical staff.

While some people claim hormone replacement therapy has improved their quality of life, Dr. Grendys is quick to add it's not for everyone. "Hormone replacement therapy should only be used in women who are severally symptomatic, non-controllable, by other means, and have no risk factors that would contra-indicate the use of hormone therapy. Some of the contra-indications include certain types of cancer that the patient may have already had: breast cancer, uterine cancer, etc."

Research continues to escalate as well. "Recent data is conflicting. Certainly, we see articles in the lay press saying that certain forms of estrogen replacement and or combined with progesterone therapy, the second component, do lead to an increased risk of specifically breast cancer, and that is a concern."

Menopause can be a physically challenging time in a woman's life. Some take HRT to help with hot flashes and other hormonal changes. This further intensifies the argument over whether or not quality of life should be compromised in order to prevent any other medical risks. "If someone is severely symptomatic from menopausal symptoms, vaginal dryness, difficulty with intercourse, severe hot flashes leading to sleep disorders, etc..." says Dr. Grendys. "At times we need to balance the risk of hormone therapy versus the benefit that the patient may receive from a quality of life standpoint, and that can become a little tricky at times."

In the midst of all of the controversy, physicians do know that certain factors will determine whether or not HRT is right for a woman. Those include family history, history of blood clotting, as well as current medical conditions and past or present cancers.