HRT – the risk and benefits

Medical authorities now consider that the conclusions from the Women’s Health Initiative trial of the use of HRT {Hormone Replacement Therapy} in 2002 to be exaggerated and vary with the age of the women and the type of progesterone used. The WHI study had led to confusion regarding the role of HRT and its real risks and benefits.

Last year, TGA {Therapeutic Goods of Australia} approved the use of the body-identical micronised progesterone which has been prescribed by integrative doctors and compounded by special pharmacies for years.  This is because a systematic review of breast cancer risk with different types of progesterone reported a statistically significant reduction in breast cancer risk for users of estrogen plus the natural micronised progesterone, whereas there was an increased risk for users of estrogen plus synthetic progesterone.

Other conclusions were that HRT improves bone density and reduces fractures.  Cardiovascular disease is not increased and may in fact be reduced. The risk of blood clots was increased amongst oral estrogen users but not non-oral (ie patches and creams).  Blood clots are also more likely in those using the synthetic progesterones.

While HRT is the most appropriate treatment for menopausal symptoms, it is not for every woman and should not be initiated in older women (generally more than 10 years post-menopause).

~ Dr Julie Bradford ~ 

MBBS, FABAAARM, FAAAM, FFMACCS, FACNEM, FCPCA, FMMO

Bradford Clinic