The Risk and Benefits of Estrogen Hormone Therapy for Postmenopausal Women

Collective attention is lacking on the recommendation of estrogen therapy (ET) in postmenopausal women. For advanced practitioners (APRN), an explanation is needed to inform clients about the risks and benefits of using menopausal hormonal therapy. In the United States, breast cancer is the second most common cause of death from female cardiovascular disease, the etiology of which has recently been elucidated (Eccles, 2013). The number of years the client uses hormonal therapy and the lifestyle of each client can aggravate breast cancer (Beckmann, 2014).

Estrogen and hormonal therapy: The combination of estrogen, estrogen and progesterone (hormonal therapy) is approved for the treatment of moderate to severe hot flashes and vaginal dryness, which may be related to the prevention of postmenopausal osteoporosis and menopause . Estrogen without progesterone is recommended only for women who have undergone hysterectomy (surgical resection of the uterus). Estrogen increases the risk of endometrial cancer and progesterone reduces this risk.

Studies by the Women's Health Initiative showed that there is a serious risk for hormone replacement therapy (including estrogen, estrogen and progesterone only). It increases the risk of breast cancer, stroke and thrombosis and does not reduce the risk of heart disease as expected. Considering the risk, hormone replacement therapy should be prescribed on a case by case basis. According to the US Food and Drug Administration, women who are currently approved for postmenopausal symptoms but are recommended to start hormone replacement therapy are advised to try the lowest dose in the shortest time . Only women at risk for severe osteoporosis who can not receive nonestrogen therapy should consider hormone replacement therapy for prophylactic treatment.

Hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT) or postmenopausal hormone therapy (PHT, PMHT), is a hormonal therapy used to treat female menopausal symptoms. These symptoms include hot flashes, vaginal atrophy and dryness, bone loss, and the like, caused by a decrease in sexual hormone levels during menopause. The main hormonal drugs used by HRT for menopausal symptoms are estrogen and progesterone. Prohormone-free treatment is associated with endometrial hyperplasia and cancer, progesterone prevents these risks, and progestogen is often combined with estrogen in women with uterine integrity. Androgens such as testosterone are occasionally used in HRT. HRT drugs are in various forms and can be used in a variety of different routes of administration.