Long-Term Hormone Therapy: Risks and Alternatives for Women

Hormones

Hello, doctor.
My mother had uterine fibroids about ten years ago, and after consulting with a gynecologist, she followed the recommendation to undergo a hysterectomy and oophorectomy.
Since the surgery, she has been receiving monthly injections of a Dutch synthetic hormone.
However, I recently read a report stating that long-term hormone injections can be harmful to the body.
My mother is now sixty years old, maintains a healthy diet, exercises regularly, and is in good health, appearing like a woman in her forties or fifties.
Aside from experiencing occasional eye strain, she has no significant health issues.
However, she mentions that if she misses an injection or is late by even a little, she experiences bone pain and blurred vision.
Therefore, I would like to ask if the report is accurate.
Is long-term hormone therapy a correct medical approach? Are there alternative methods to supplement hormones? Thank you very much!

tián tián quān, 20~29 year old female. Ask Date: 2001/08/15

Dr. Zhan Deqin reply Obstetrics and Gynecology

The purposes of hormone replacement therapy after menopause or ovarian removal are: 1.
To prevent osteoporosis 2.
To prevent aging and dementia 3.
To treat menopausal symptoms such as hot flashes and palpitations.
The only side effect is an increased incidence of breast cancer.
Hormones are best taken orally rather than through injections.

Reply Date: 2001/08/15

More Info

Long-term hormone therapy, particularly for women who have undergone surgical procedures such as a hysterectomy, can be a complex topic that requires careful consideration of both the benefits and risks involved. Your mother's situation, having had her uterus and ovaries removed due to uterine fibroids, places her in a category where hormone replacement therapy (HRT) is often prescribed to alleviate symptoms associated with estrogen deficiency, such as bone pain, mood swings, and hot flashes.

Firstly, it is essential to understand that hormone therapy can be beneficial for many women, especially those who experience significant symptoms due to the sudden drop in hormone levels following surgical menopause. In your mother's case, the monthly injections of a Dutch hormone preparation likely serve to maintain her hormone levels, which can help prevent symptoms like bone pain and visual disturbances. However, the long-term use of hormone therapy has been associated with various risks, including an increased chance of certain types of cancer (such as breast and endometrial cancer), cardiovascular issues, and thromboembolic events.

The concerns raised in the newspaper article you mentioned are valid and reflect ongoing debates in the medical community regarding the safety of long-term hormone therapy. Studies, such as the Women's Health Initiative, have shown that while hormone therapy can provide relief from menopausal symptoms and protect against osteoporosis, it may also carry risks that need to be weighed against the benefits.
For women like your mother, who are otherwise healthy and active, the decision to continue hormone therapy should be made in consultation with a healthcare provider. Regular check-ups and assessments can help monitor her health and adjust her treatment plan as necessary. It is also crucial to evaluate her specific health history, family history of cancer, and any other risk factors she may have.

In terms of alternatives to hormone therapy, there are several options available. Lifestyle modifications, such as maintaining a balanced diet rich in calcium and vitamin D, engaging in regular weight-bearing exercise, and managing stress, can significantly impact overall health and well-being. Additionally, non-hormonal medications, such as selective serotonin reuptake inhibitors (SSRIs) or gabapentin, may be prescribed to help manage specific symptoms like hot flashes without the risks associated with hormone therapy.

Furthermore, some women explore natural supplements or bioidentical hormones, although the efficacy and safety of these alternatives can vary widely. It is essential to approach these options with caution and consult with a healthcare provider before making any changes to her treatment plan.

In conclusion, while long-term hormone therapy can be an effective treatment for managing symptoms of menopause and preventing bone loss, it is not without risks. Your mother's health status, lifestyle, and personal preferences should guide the decision-making process. Regular communication with her healthcare provider will ensure that she receives the most appropriate care tailored to her needs. If she experiences any concerning symptoms or side effects, it is crucial to address these promptly with her doctor to explore alternative treatments or adjustments to her current regimen.

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