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Considering HRT? 

         Read This First

 

 

 

HRT is not without its risks, cautions Dr. Walsh. The greatest  concern is whether taking HRT will increase the risk if uterine or breast cancer. 

 

Of postmenopausal women not taking HRT, one in 1,000 will develop uterine cancer, according to studies. For women  who take  estrogen alone, that risk increases between two and ten times , depending  on how much estrogen is in the formulation they take  and how long they take it. 

 

Studies indicate, however, that when protesting is taken with estrogen, the resk of uterine cancer is lower than when estrogen s taken 

 

HRT Options: Choosing The Therapy That's Right For You

 

Not all hormone replace therapy (HRT) prescriptions are the same. There are different timetables for taking the formulates, which, can cone as  a patch or pill. 

 

In one type of HRT, called sequential therapy, estrogen is taken every day for two weeks. Then , on the  15th day protesting is taken as will, Both  estrogen and protesting are continued from day 15 through day 25, and then both are withdrawn. It's at this time that menstrual-like bleeding begins. 

 

Estrogen creams are often used by women who  experience vaginal dryness. The cream is inserted with an applicator directly into the vagina, where it works to  replenish vaginal tissue. In the  beginning, vaginal estrogen cream is used three to four times a week, until vaginal symptoms imp toms improve. Then it's used less frequently. 

Estrogen patches are often the choice of women who want to take HRT but can't take estrogen orally because of a small bandage and is worn on the lower abdomen.  the estrogen is absorbed through the skin and Then released directly into the bloodstream in  timed sequences. 

 

Estrogen pills are taken by mouth, according to the regimen set by your doctor. Premarin is the  most  commonly used pill. It's a natural form of estrogen mare's estrogen Whereas some other estrogen pills are synthetic. 

 

How effective HRT is in fighting heart disease depends on which type of estrogen you use, according to Brian Walsh, M.D., director of the Menopause clinic at Brigham and Women's Hospital in Boston. Estrogen creams and the patch are not as effective as pills . With the pill, estrogen passes through the  digestive tract and liver, where it exerts its impact on cholesterol. With the patch and cream,  however  estrogen goes directly into  the bloodstream, and the effect on cholesterol is diminished. 

 

 

By itself. It a ten year study of 398 women taking both hormones, none 0f there women who took protesting for at least 10 days out of 25 developed uterine cancer Whether w0men who take HRT are lower risk for uterine cancer than women who don't take any hormones has not been conclusively proven, but based on preliminary studies, doctors suspect that the risk may be lower by an estimated 30 to 40 percent. 

 

 If a woman decides to take only estrogen, she can be monitored for uterine cancer by her doctor. 

 

Breast cancer is a concern for women on HRT, Estrogen promotes cancer growth in lab animals, so there's reason to suspect that  giving women estrogen might stimulate breast cancer. While research on breast cancer risk from HRT has yielded no definite conclusion, a study conducted at the centers for Disease Control and  prevention in Atlanta determined that a woman's may be relative to how long she's on the  therapy. women who did not take HRT or took it for less than 5 year. 

 

 Women who take HRT are also at risk for gallstones, particularly during  the first year of therapy, says Dr. Walsh. Also if you've had  cancer of the breast or uterus, have active liver disease or have had major problems with blood clots, HRT is not  usually recommended. 

 

A Pre-menopause " To -Do" List 

 

 Menopause may bring some physical changes, but thefre arr some steps you can take now to help you get throuth it, Here are some suggestions. 

 

Get active: Do some form of weight bearing aerobic exercise for 30 minutes at  least three times a week, and more if possible, Weight bearing bone  density. Aerobic exercise, the kind that  gets your heart  rate up continuously for at least 20 to 30 minutes, will also help keep your cholesterol level down and boost your feeling of well -being. Dr. Walsh says. 

 

Eat less fat: Watch your fat intake : 25 percent or less  of the calories eat should come fro fat experts asy .Eating  diet low in saturate fats will help bring your cholesterol level down.

 

Kick the  butts : Smoking can worsen any menopausal symptoms you have, Dr, "Wash says, Smoking not only brings on menopause sooner, it also reduces the small amount of  estrogen women do have after menopause. In addition to Making you feel better at menopause, Quitting the cigarette habit will also be better for your bone health. you'll have more estrogen available to maintain  your bone  strength. 

 

Consume calcium: Get enough calcium to keep your boshes strong  and healthy . After age 35, women begin to lose about I percent of their bone mass per year. The Daily Value for calcium for premenopausal women is 1,000 milligrams, but some doctors recommend getting between 1,000 and 1,200 milligrams. An eight ounce glass of I  percent low fat milk and one cup of low fat yogurt with fruit contain about 300 milligrams each. Three ounces of canned sockeye sal on, with bines, contains about 203 milligrams, and a half cup of tofu contains about  258 milligrams. 

 

Calcium supplements are another option. When deciding how many supplements to take, read the label to see how much " element of milligrams your body will actually absorb, take the supplements  with food ad a glass of water  to help your body absorb thm easily and efficiently, Says  Kendra kaye, M.D. clinical assistant professor of medicine at the University of Pennsylvania School of  Medicine 2nd attending physician at Graduate Hospital,, both in Philadelphia. 

 

Watch your cholesterol : Ask your doctor to check your cholesterol levels to make sure you are in the healthy range, says Dr, Walsh. She should measure the ratio of your total cholesterol to your good cholesterol or HDL. A total cholesterol/HDL cholesterol ratio between 3.5 and 6.9 means you are at moderate risk, and a ratio over  7.0 means you are at high risk. Menopause can cause your ratio to go upm, because levels of LDL ( Cholesterol) go up and levels of HDL good cholesterol ) go down. 

 

Monitor yours symptoms: See your doctor if you have PMS and  yours symptoms are getting worse: you may have begun menopause says Dr. Klutznick. Your Doctor can perform a follicle stimulating hormone test to determine whether that is the case . 

 

Talk to Mom : It the uncertainty of menopause weighs on  your mind, told you your mother about  it. It's  not uncommon for  women to follow the same pattern as their  mothers, says Dr, Walsh especially if they have a similar health history . 

 

...... And to your spouse: Share information you learn about menopause with your husband, says Dr, Klutznick. One  way to  do that is to ask him  to read a book or two on menopause, she  says Some books have chapters just for men. 

 

Savor the moment : Appreciating where you are in your life  and  enjoying it can make the menopausal transition easier, says  Borton. 

 

Taking Charge of the change 

 

 Don't just sit back and worry, or try to ignore it. Here are  tips to help you cope.

 

Reach out : " Talk to other women " says Dr. Klutznick. Find  out what symptoms they're having what causes them difficulty and what they do to cope. A lot of women are doing  their own research  and information-gathering and they can bve a tremendous resource for you she says.

 

Find a mentor: Some older  women who have been through menopause can serve as wonderful mentors, says Borton. Find  a women 10 to 15 years older who's living a lifestyle you admire and talk to her about what has meaning in germ life . Make her a role  model. 

 

Known your options :  Talk to your doctor about your  symptoms and optins for dealing with them . Deciding to several doctor if you need to  Dr. Klutznick says, until you find one you are comfortable with and who is willing  to respect what you want to do to manage your menopause. 

 

Stay connected : " Women need to have a community of  other women, " Says Dr. Klutznick. This can help you feel connected productive during this  transitional time  she says. So join a book club or take art lessons or a course that stimulates your intellect she says.

 

Expect sexual changes: some women find that sex is not as passionate but  becomes more affectionate. and this can be fine, since their mate's  testosterone levels may be dropping as will, lowering his sex drive. Some women also find that certain places on the body that  used to be  highly sensitive are less so, and that  other places that were not sensitive now are, says Dr. Klutznick. 

 

Explore sexual options : Try to stay sexually active, doctors say. Not having sex can cause your vagina to change in size and elasticity,  which can make sex painful. communicate to your partner the  changes you are feeling and explore new and different the changes you are  feeling and explore new and different ways to have sex that may be more comfortable. 

 

You may take longer to lubricate than you used to. Besides allowing yourself more  time, you can also use water based vaginal lubricants. Try K-Y Jelly or Replens, which are available in drugstores. 

 

If you do not have a partner, masturbation helps promote circulation and moistness in the vagina, helping it to Maintain its size and elasticity, says Dr. Klutznick. 

 

Consider herbal remedies: Black cohosh, blue choosh, serape rilla wild yam root and dong quai are among some of the herbs doctors often recommend to alleviate menopausal symptoms. These herbs contain phytoestrogens, plant sources of estrogen similar to that  produced in the body. 

 

The levels of phytoestrogens found in these herbs are lower than the doses of estrogen in HRT and are believed by some  doctors  to relieve menopausal symptoms without causing harmful side effects. Consult with your doctor before using these remedies. 


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