Story at-a-glance

Between 2001 and 2011, estrogen replacement therapy in women aged 50-59 dropped 79 percent. New research suggests that estrogen avoidance may have led to the premature death of about 50,000 women in medical menopause
The study found that estrogen therapy for women in medical menopause was associated with “a decisive reduction in all-cause mortality,” primarily by reducing deadly heart attacks and deaths from breast cancer
Your risk-to-benefit ratio is likely related to a combination of factors: surgically-induced menopause vs. natural menopause vs. using HRT for preventive purposes; your age; using bioidentical vs. synthetic hormones; delivery method
If you’re in medical menopause, avoiding HRT due to fears about side effects could be a mistake. I recommend discussing your individual situation with a physician well-versed in bioidentical hormone replacement

HRT still makes sense for a lot of women.

“If you look at the science carefully enough, the two-to-five-year period that most women need HRT to get through this transition is relatively safe,” says Michelle Warren, MD, medical director of the Center for Menopause, Hormonal Disorders and Women’s Health at Columbia University. In the research, breast cancer risk didn’t rise until after five years of use. In other research, if women began taking HRT within ten years of entering menopause, their risk of heart disease was unaffected. Making a decision about therapy has gotten considerably easier.

If hot flashes, insomnia, vaginal dryness, or other symptoms are making you miserable, HRT is a good choice

Women with milder symptoms may want to try other options before HRT. relief through working out regularly; avoiding alcohol, caffeine, and spicy foods; using water-based vaginal lubricants; and regularly doing Kegel exercises. Low-dose antidepressants such as Prozac or Celexa can moderately reduce hot flashes and improve mood.

HRT remains the most effective treatment for severe menopause symptoms, says Warren: “It’s a shame to think women are out there suffering because they aren’t getting the help they need.”

From the issue of O, The Oprah Magazine

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