Hormone replacement therapy: benefits and adverse effects

Several researches indicate that estrogen replacement therapy (ERT) is an efficient remedy for vasomotor symptoms, insomnia and vaginal dryness. Benefits are also shown on lipid patterns and on the incidence of osteoporotic fractures. As ERT estrogen replacement therapy enhances the risk of endometrial adenocarcinoma, combinations with various progestogens have been developed in order to safeguard the endometrium. Nonetheless, the inclusion of progestogens will probably lessen the beneficial effects of estrogens on mood, cognition and lipid metabolism. The additional progestogen usually leads to negative effects for example irritability and depression. There’s proof that the impact on wellbeing varies between women and with the kind of progestogen used. Ladies who choose to avoid withdrawal bleedings can be given constant combined hormone replacement therapy (HRT). Sadly, irregular bleedings are typical at the outset of treatment and minimizes compliance. Lately, a number of reports have reported a heightened chance of breast cancer and venous thrombosis, and thus long-term cure with hormone replacement therapy HRT for females without climacteric indications is no longer advised. The continuing debate has, for the moment, triggered a recommendation that bettering quality of life (QoL) by treatment of climacteric symptoms ought to be the only indication for recommending HRT….


Context and background
Pre-study expectations
Hot flushes and HRT
HRT and the endometrium
Wellbeing and hormone replacement therapy HRT
Compliance with HRT
Premenstrual syndrome and HRT
Cognition and depression
HRT and cardiovascular disease

Alternative therapy
Present study
Ethical considerations
Multicentre study sites
Demographic data
Bleeding diary and medication
Daily symptom ratings
The diagnosis of premenstrual syndrome
Lipid and lipoprotein assays
Baseline characteristics
Serious adverse events
Bleeding patterns
Wellbeing at onset of hormone replacement therapy HRT
Wellbeing during long-term treatment with HRT
Lipids and lipoproteins
Methodological strengths and weaknesses
Reasons for dropout
Effects on bleeding patterns
Measuring wellbeing
Effects on wellbeing
Side effects
HRT hormone replacement therapy and cardiovascular risk
Conclusions and some thoughts for the future

Source: Umea University

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