Hormone replacement therapy – how safe is it today?
Hormones have us firmly in their grip not only during menopause. They are therefore rightly called the directors of life. What should we do if they get out of balance during menopause? How safe is hormone replacement therapy today?
Unfortunately, there is no single opinion on who should take hormones, when, and for how long. The well-known gynecologist Dr. Sheila de Liz recommends hormone replacement therapy to virtually every woman in and after menopause: “After a certain age, hormone deficiency runs in the background like chronic vitamin deficiency. The damage doesn’t show up right away and doesn’t show up until later, such as vaginal problems or incontinence.”
Asked about women’s worries regarding hormone replacement therapy, the doctor even speaks of a hormone phobia, which is mainly triggered by the WHI study. “The fears are largely unfounded, however, because the drugs used back then cannot be compared at all with today’s preparations: “In the past, artificial hormones were prescribed in pill form, estrogens and progestins were administered in one pill. The new hormones, on the other hand, correspond exactly to the biological original and are therefore not foreign to our bodies.”
Hormone replacement therapy as early as 40?
Munich-based private lecturer and gynecologist Dr. Silke Dabelstein also advocates compensating for hormone deficiencies, but only if there are actual complaints. “Then, however, one should not wait too long with hormone replacement therapy.” The problem, she says, is that many sufferers don’t even think of their complaints as being related to menopause. “For example, irregular and spasmodic bleeding, migraines, weight gain or joint pain can be the first signs of menopause and can already occur in the early 40s,” explains Dr. Dabelstein And Dr. de Liz emphasizes, “It is not uncommon for patients in premenopause to lack the feel-good hormone progesterone, while they even have estrogen in abundance.”
And what are the risks and side effects of hormone replacement therapy from today’s point of view? Unfortunately, there is no unanimous opinion among experts on this either. “In my view, clear contraindications are an increased risk of breast cancer and thrombosis,” explains Dr. de Liz. “Otherwise, in my practical experience, the health benefits outweigh the risks, such as genital and vaginal health, protection of the urinary bladder, more energy and mental fitness, and preservation of libido.”
Cream instead of swallow
Hormone levels can be determined very easily with a saliva or blood test. And how long can or should hormones be taken? Dr. Dabelstein argues: as long as necessary, but as short and individual as possible, while Dr. de Liz sees no age limit as long as the hormones are controlled and individually adjusted.
However, the experts largely agree on one point: For estrogen, it is true that creams are definitely better than swallowing. Hormones administered transdermally do not affect the liver, stomach or intestines. Instead, the active ingredients enter the bloodstream directly and can therefore be administered in lower doses. Progesterone is still available in pill form, and the dose and use of both hormones should be tailored to the individual and monitored very regularly (at least every six months).