Menopause and Estrogen Replacement Therapy

Estrogen Replacement Therapy (ERT) increases the level of estrogen in the body. Estrogen replacement is used for women who are in menopausal stage with no uterus. According to the Journal of American Medicine, estrogen replacement during early to late periods of menopausal stages have been proven to give the highest protection against bone deterioration. Approximately, 15% to 20% American women use estrogen hormone therapy.

Women younger than 40 years old may experience menopausal symptoms after having an oophorectomy, which is the removal of the ovaries due to medical reasons like cancer. The usual age that a woman experiences menopause ranges form 45 to 58 years old.

Types of ERT
There are 2 types of ERT:
• Estrogen alone via pill, gel, patch, and cream
• Cyclical therapy where estrogen pill is taken plus a another progesterone pill

Who Should Not Receive ERT?
It is not advisable to use estrogen hormone therapy when a woman is/has:
• Risk of stroke
• History of blood clots
• Pregnant
• Active liver disease
• History of breast, ovarian, or endometrial cancer
• Smoker

The advantages of ERT that are beneficial to women are:
• Mainly it prevents occurrence of osteoporosis and promotes increase of bone density
• Reduces the risk of dental problems
• Preserves the lining of the vaginal wall
• Improves depression and sleep problems
• Lessens the frequency and severity of hot flushes
• Increases skin collagen preventing wrinkles all over the body

Risks of ERT
While there are positive benefits, disadvantages also follow ERT which include:
• Risk of breast cancer
• Risk of endometrial and ovarian cancer
• Risk of stroke
• Occurrence of blood clots around the legs
• Dementia
• Gallstone

Side Effects
Side effects are common with oral estrogen replacement. Side effects include:
• Breast tenderness
• Nausea
• Headaches
• Weight gain
• Vaginal discharges
• Fluid retention
• Spotting in the skin, especially the face

Headaches, nausea, weight gain, and breast tenderness usually fade after few weeks of ERT. ERT patch can cause skin irritation. The patch must not be exposed to sunlight because it increases the amount of hormone released by the patch. Aside from that, ERT vaginal rings must be replaced every 3 months.

Prevention and Managing
Millions of women around the world take hormone replacement to ease symptoms of menopause. But not every woman experiences the troublesome symptoms. When taking care of a woman who is in menopausal stage, instruct her to have regular exercises to relieve hot flushes.

Avoiding spicy food and caffeine can also prevent hot flushes. A low fat, low cholesterol diet can help prevent heart disease for menopausal women. Moreover, adequate amount of calcium in the body by drinking milk and eating food rich in calcium can prevent or slow the progression of osteoporosis.

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