V. Reasons why you should or should not get hormone replacement therapy

Hormone replacement therapy (HRT) may be prescribed to a menopausal woman, if she is experiencing symptoms such as VASOMOTOR (hot flashes), GENITOURINARY (vaginal dryness), EMOTIONAL and SLEEP issues that cannot be remedied by alternative means. These medications which can include both estrogen and/or progesterone can be administered in a variety of ways (orally, transdermal patch, transdermal cream, subcutaneous pellets and locally with vaginal creams, capsules and tablets). Many women can note tremendous improvement in menopausal symptoms. But, HRT is not for everyone which is why you should talk to your doctor before considering this treatment regimen.

Women with the following symptoms, histories or health issues should likely avoid HRT.

i. Personal history of breast cancer, ovarian cancer or uterine cancer

These cancers are typically estrogen dependent cancers. What that means, is that estrogen can stimulate these types of cancer cells to grow. Therefore, estrogen should be avoided to prevent stimulation and therefore progression of these diseases.

ii. A strong family history or a genetic mutation that increases risk for estrogen dependent cancers

If someone carries a genetic mutation that puts her at an increased risk for an estrogen dependent cancer or there is a strong familial predisposition, then she may want to be cautious in using supplemental estrogen. Caution and surveillance is very important under these conditions.

iii. Unexplained vaginal bleeding

If a menopausal woman is experiencing vaginal bleeding, then she needs to undergo a workup before starting or continuing on HRT. Although most of the time the ergology of post-menopausal bleeding is not related to a cancer, this must be ruled out, and can be done by an exam, ultrasound or uterine sampling.

iv. Blood clotting disorders

If a woman has a risk factor for a blood clot, either due to a clotting disorder or had a blood clot in the past when she was pregnant or on hormonal estrogen contraception, then she should avoid HRT. This is because HRT can increase risk for forming a blood clot.

v. Cardiovascular disease

Women with a personal or family history or increased risk factors should be mindful if considering HRT. Some studies show that heart disease and stroke can be increased with estrogen use.

Verbena does not provide medical advice, diagnosis, or treatment and is not a medical provider. Discuss all/any menopause or hormone replacement therapy issues, questions or concerns with your personal doctor.

If you think you may have a medical emergency, call your doctor or 911 immediately.