Side Effects from Hormone Replacement Therapy
As with all medicines, there are side effects associated with Hormone replacement therapy. Some women taking Hormone replacement therapy may experience water retention, bloating, nausea, breast soreness, mood swings, and headaches. Changing the dosage or the form of Hormone replacement therapy may help to alleviate these side effects.
Some women have irregular bleeding when they start taking Hormone replacement therapy, but changing the dosage often eliminates this side effect.
Summary of Risks/Benefits
The WHI study shows relatively small absolute increases in the risk of heart disease, breast cancer, blood clots, and stroke to an individual woman. However, when the entire population of postmenopausal women and the number of years a woman may be on Hormone replacement therapy are considered -- the number of strokes, heart attacks, breast cancer cases, and blood clots appears to outweigh the protective effect of Hormone replacement therapy on bones.
Some women may still wish to consider Hormone replacement therapy for short-term treatment of menopausal symptoms. The key is to weigh the risks associated with taking Hormone replacement therapy against a particular woman's risk of heart disease or osteoporosis without taking Hormone replacement therapy. Every woman is different. Therefore, your entire medical history should be evaluated individually when considering Hormone replacement therapy.
Forms of Hormone Replacement Therapy
Hormone replacement therapy is available in various forms, including pills, patches, and vaginal creams. Your health care provider will start you on a regimen that is best suited for you. It may be necessary to try more than one regimen before finding the one that works best for you.
Cyclic hormone therapy is often recommended. With this therapy,
estrogen is taken in pill form for 25 days, with progestin
added somewhere between days 10 - 14. The estrogen and progestin
are taken together for the remainder of the 25 days. Then,
no pills are taken for 3 - 5 days. There will be monthly bleeding
with cyclic therapy.
Continuous, combined therapy is where estrogen and progestin are taken together every day. When this therapy is started, or when switching from cyclic to continuous therapy, women may experience irregular bleeding. Most women stop bleeding within one year after starting this therapy.
Hormone replacement therapy is also available as a patch which
is applied to the abdomen or the thigh. This patch allows
the estrogen to be absorbed through the skin into the bloodstream.
Some women prefer this method because they do not have to
Vaginal cream containing estrogen may be given to women for vaginal dryness. The cream is usually given along with one of the other forms of Hormone replacement therapy because the cream may not relieve many of the other symptoms and does not appear to protect against bone disease.
Additional medications may be recommended for some women with severe symptoms from menopause, or women who are at very high risk for osteoporosis or heart disease. One of these supplemental drugs might be androgen, a male hormone given with estrogen to relieve severe hot flashes.
In addition to taking Hormone replacement therapy, there are other things that can help women adjust to the changes in life during menopause. Eating healthy foods and getting regular exercise will also help to decrease bone loss and maintain healthy heart muscle.
Calling your Doctor
Talk to your doctor about the risks and benefits of taking estrogen and progestin.
If you experience any of the following side effects, call your doctor immediately:
- sudden, severe headache
- sudden, severe vomiting
- sudden partial or complete loss of vision
- speech problems
- dizziness or faintness
- weakness or numbness of an arm or a leg; crushing chest pain or chest heaviness
- coughing up blood
- sudden shortness of breath
- calf pain