Whether to take some form of hormone replacement therapy (HRT) after menopause to mitigate unpleasant symptoms has been a subject of discussion and controversy for women for decades. Experts have argued the health benefits and risks with hypotheses that have vacillated from “nothing short of a miracle” to “posing grave danger of increased risks of heart disease, stroke and breast cancer.” Throughout this confusion, women have faced the difficult decision of whether to take their chances and take HRT, or just live with the disruptive and sometimes debilitating effects of the menopausal transition.
Finally, there is clarity. This September, the findings of an 18-year, 27,000-subject study, published in the Journal of the American Medical Association provided conclusive evidence that neither the effusive hype nor the dire warnings were warranted. The findings are the result of hormone therapy trials conducted by the Women’s Health Initiative (WHI), and represent the largest and most comprehensive study to assess the effects of HRT. The conclusion is that most women who initiate hormone replacement therapy under age 60, or within 10 years of reaching menopause, for an average of six to seven years (no more), it’s safe and can improve quality of life, increase productivity and reduce medical expenditures linked to untreated symptoms of menopause.
Well-Being reached out to Mickie Autry, PhD, NP-C, Menopause & Sexual Wellness Nurse Practitioner at Ovation Women’s Wellness in Flowood about the impact this study could have on how women will make informed decisions about hormone therapy going forward.
According to Ms. Autry, the current research, just released by the WHI, has provided some conclusive evidence that should provide confidence in providers in prescribing menopausal hormone therapy and women in taking therapy in order to abate physiological symptoms and provide some protective long-term benefits.
“The findings of the study demonstrate with confidence that synthetic hormone therapy given for women who enter menopause and suffer from menopause related hot flashes, night sweats, and sleep disruption and risk of bone fractures are safer than previously determined,” notes Autry.
“The research and current practice of medicine is to discontinue hormone therapy at the age of 60, Autry continues. “However, I feel that women whose quality of life are negatively impacted by menopausal symptoms, such as vasomotor, sleep disturbance, heart palpitations, depression, irritability, anxiety, exhaustion, sexual dysfunction, vaginal dryness, bladder issues, and joint and muscle pain, should be provided with the risk of benefit of therapy and so they can make decisions based upon a clear discussion between the provider and the patient.”
While menopausal hormone therapy continues to evolve and more preparations are available, synthetic hormone therapy remains the mainstay of therapy at the present time.
Bioidentical hormones are chemically prepared to be more “identical” in chemical structure to what the ovaries in a pre-menopausal woman have always produced naturally.
“In my personal and professional opinion, bioidentical hormone therapy preparation options should be explored more by the pharmaceutical companies,” Autry concludes.
Mickie Griffith-Autry, PhD, NP-C, earned her Bachelor of Science degree in nursing from Jacksonville State University, her Master of Science degree in nursing from the University of Alabama Huntsville, and her PhD from Walden University. Her research dissertation was entitled Pelvic muscle strengthening: Impact on sexual functioning in the menopausal woman.