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There were more deaths from breast cancer, as well as from all causes, after a breast cancer diagnosis in women who took estrogen plus progestin than in women who took placebo. During the 18-year follow-up period, there were more breast cancer deaths in BHRT women taking combined hormone therapy and fewer breast cancer deaths in women taking estrogen alone, compared to women taking placebo. The American Cancer Society says that estrogen-only HRT is not associated with an increased risk of breast cancer.

Estrogen hormone therapy alone and combined hormone therapy are the two main types of hormone replacement therapy. If you still have your uterus, your doctor will suggest combination therapy because progesterone reduces your risk of endometrial cancer. Many, though not all, women experience unpleasant symptoms before and after menopause, including hot flashes, night sweats, sleep disturbances, and vaginal dryness. These symptoms and physical changes can be treated in a variety of ways, including lifestyle changes, such as healthier diets and increased exercise, and through hormone replacement therapy. Hodis conducts further studies on why hormones can fight brain fog, inflammation, and other changes that occur along with menopause. His latest research tests a combination of conjugated estrogen and bazedoxifene, which is not a hormone but acts as one in the body.

Systemic MHT is usually prescribed to treat hot flashes and prevent osteoporosis. Systemic MHT with combined estrogen plus progestin or with estrogen can only be administered as oral medications; such as transdermal patches, gels or aerosols; and as implants. Women who took combination hormone therapy or estrogen alone had an increased risk of stroke, blood clots, and heart attack. However, for women in both groups, this risk returned to normal levels after they stopped taking the drug. But it is very important to know that in women who have a uterus, the use of systemic HRT with estrogen alone has been shown to increase the risk of endometrial cancer.

In fact, the treatment increased women’s risk of having a heart attack in the first year of hormone use. In the HERS follow-up study, participants were monitored for about 3 more years. This study showed no lasting decrease in heart disease caused by estrogen plus progestin.

Women who are concerned about changes that occur naturally with the decrease in hormone production during menopause may make changes to their lifestyle and diet to reduce the risk of certain health effects. For example, eating foods rich in calcium and vitamin D, or taking supplements that contain these nutrients, can help prevent osteoporosis. FDA-approved drugs such as alendronate (Fosamax®), raloxifene (Evista®), and riedronate (Actonel®) have been shown in randomized trials to prevent bone loss.