Hormone replacement therapy is a medical treatment administered to women after undergoing hysterectomy (removal of uterus) or upon reaching menopausal stage. It uses a medication containing hormones such as estrogen, progesterone or testosterone, which can treat symptoms associated with menopause that include hot flashes, vaginal dryness, anxiety and sleeping disorders. Just like any medical treatment, hormone therapy has health risks that women should consider before undergoing treatment.
Taking estrogen increases the risk for blood clots, which becomes higher if the person taking also smokes or takes birth control pills. According to a study conducted by the Women’s Health Initiative on 16,000 women in 2002, blood clot rates were more than twice as high with those taking hormone replacement therapy.
The risk of blood clot in the legs (deep vein thrombosis) and lungs (pulmonary embolism), which can be life-threatening, is greatest during the first year of use. Hormone replacement therapy slightly increases clotting factor in the blood when taken orally, but not as much when taken through skin absorption (patches).
Cardiovascular disease is the leading cause of death in women as well as in men. According to John Hopkins Medicine, about 20,000 females under the age of 65 die of coronary heart disease each year, about 35 percent of them under the age of 55.
The WHI study showed that taking hormone replacement therapy could increase a woman’s risk of heart disease. The rate for heart disease was 29 percent higher and stroke rates were 41 percent higher in patients who were taking hormones compared to those who were not. The study does not recommend women with heart disease or women who have had a stroke to take hormone therapy.
Taking estrogen alone can increase the risk of endometrial cancer (lining of the uterus). Women who still have an intact uterus should take a combination of estrogen and progestin (synthetic progesterone) to reduce this risk. Progestin can prevent the overgrowth (or hyperplasia) of cells in the lining of the uterus.
Unfortunately, according to the WHI study, the combination estrogen and progestin can increase the risk of breast cancer by 26 percent, which are eight or more breast cancers each year for every 10,000 women. The risk increased in women who were taking the combined hormones prior to the study, which indicates that the therapy may have a cumulative effect. There are no clear findings if using hormone replacement therapy can cause ovarian cancer.
Gall Bladder Disease
Women who use estrogen replacement therapy are more likely to have gallstones that cause symptoms than women who do not use it. There is a link between high estrogen levels to gallbladder disease. According to the Journal of American Medical Association, there is an increase in risk of biliary tract disease among postmenopausal women using estrogen therapy.