What Women should know about the Hormone Replacement Therapy

Whether it is a naturally occurring event in a woman’s life, or whether it is something that occurred after a recent surgery or chemo/radiation therapy treatment – menopause is a change that may surprise the unsuspecting or uninformed woman. Most women faced with menopause automatically start with the question, “What kind of HRT should I choose?” This is the wrong approach. Patients need to become more informed before they sit down to have that conversation with their doctor.

Not too long ago during my medical school clinical training, I witnessed an exchange between a 26 year old woman scheduled to undergo a total hysterectomy for severe endometriosis and her consulting doctor.

The patient had been suffering from the disease since her teenage years. On her office visit to her urologist, she was asked, “What do you plan to do about your hormones?” She suddenly became perplexed and just managed to mutter, “What do you mean?” I immediately felt compassion for this young woman, understanding that from a medical standpoint she was at risk for symptoms not biologically normal for a woman her age: increased risk of heart disease, bone loss, vaginal atrophy, the inability to conceive. In addition, a total hysterectomy for endometriosis would not guarantee the cessation of abdominal pain or other associated complaints. It was a complicated matter and her allotted time with the physician would not answer the many questions she had.

It became apparent to the urologist after talking to the patient more, that her gynecologist, who was scheduled to perform a hysterectomy with removal of her ovaries, did not emphasize strongly enough that the status of this woman’s hormones would be altered forever. The patient was not properly educated about upcoming menopausal symptoms or about possible hormone treatment options post procedure. While it is unlikely that this patient would have been left in the dark post treatment, the fact that she was not prepared for what was coming ahead was quite shocking to say the least. Proper background knowledge may have ultimately altered this young woman’s opinion on appropriate treatment options for her body.

This encounter made me realize that even with the vast amount of information that is available on the Internet, many patients are still not well informed. Perhaps this mass of information oftentimes disorients and overwhelms women, as it sends people down a long, winding, oftentimes confusing road. In recent years there have been a handful of books published on the topic that I found invaluable. I highly recommend that women in perimenopause read these more thorough sources to get a well-rounded foundation of knowledge.

In short, menopause is a complicated matter, whether it is early onset, surgically activated, or brought on later in a woman’s life. Women need to be brought to ground zero and do their homework rather than jump to conclusions. Easy, short term solutions may not bring about long term benefits, and it is hard for women to grasp this concept in a short 15 minute consultation without having read up on the subject thoroughly.

These books are worth reading to learn more about hormones, menopause and hormone replacement therapy:

1. Natural Hormone Balance for Women: Look Younger, Feel Stronger, and Live Life with Exuberance by Uzzi Reiss
2. The Sexy Years: Discover the Hormone Connection: The Secret to Fabulous Sex, Great Health, and Vitality, for Women and Men by Suzanne Somers
3. Sex, Lies, and Menopause: The Shocking Truth About Synthetic Hormones and the Benefits of Natural Alternatives by T. S. Wiley, Julie Taguchi and Bent Formby
4. HRT: The Answers – A Concise Guide for Solving the Hormone Replacement Therapy Puzzle by Pamela Wartian Smith