Ask the Expert: What Is Hormone Therapy?

Dr. Arlene Morales
Dr. Arlene Morales, a Sharp-affiliated reproductive endocrinologist and OBGYN, responds to commonly asked questions about hormone therapy.

How has hormone therapy changed over the years?
Up until about 5 to 8 years ago, the majority of postmenopausal women were on estrogen and/or progesterone therapy up until their 80s or late 70s, early 80s, even into their 90s.

There was a very important study called “The Women’s Health Initiative” that was published a few years ago that really had a very powerful impact on the use of hormone therapy in American women when it comes to use of estrogen and progesterone in menopause. And how this has really changed is that it’s still recognized that estrogen and/or estrogen and progesterone are the most effective therapy for treatment of hot flashes. That is noncontroversial. What has become controversial is, “Are hormone therapies important for other aspects of women’s health care?”

What are the risks of hormone therapy?
There was certainly a lot of concern that either estrogen or estrogen with progesterone may have an impact in increasing the risk of breast cancer. And because of that, there are multiple ongoing studies that are hopefully going to shed light over the next 5 to 10 years about trying to identify those women that may be at increased risk with hormone therapies. 

There was also concern that has long been known, but not very well delineated, of an increase in what is called thromboembolic risks or blood clots. And we think that mainly it has to do with the dose of estrogen. So there certainly are risks that are now much more well defined, specifically the issue of breast cancer and the issue of blood clots. 

What are the benefits of hormone therapy?
But there are also benefits, again, to emphasize the importance of estrogen for tools of hot flash therapy. And it is a tool for vaginal dryness. It also has an important role in bone stabilization as far as helping decrease fractures of the hip and the spine.

Should I or should I not be on hormones?
The quickest answer to that is that every person has to be individually assessed. If you are a woman who, unfortunately, does not get a lot of exercise, has poor eating habits and is obese, there is no pill that is going to minimize all your risk factors anywhere near as effectively as being able to improve your exercise, improve your diet and lose weight.    

For More Information
To learn more about Sharp's women's health services or to find a Sharp-affiliated doctor, search for a San Diego OBGYN or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm. To find general information about women's health, visit Women's Health in Adult Health or read the Women's Health News archive.