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The benefits and risks of taking HRT to treat the symptoms of menopause

Menopause is the natural point in a woman’s life when her ovaries stop producing the hormones estrogen and progesterone and her menstrual periods stop. This usually happens between the ages of 45 and 55 but can vary. A woman may reach menopause early as a side effect of medical treatment such as chemotherapy or having her ovaries removed.

Symptoms of menopause include hot flashes, mood swings and trouble sleeping, but every woman’s experience is different. Some women may not be bothered by symptoms, while others may find it hard to cope with them. Treatment options are available to help ease symptoms. image of an woman talking to a doctor

Why would a woman in menopause take HRT?

Some women take hormone replacement therapy (HRT) to ease menopausal symptoms. HRT is medicine that contains hormones that the ovaries make less of as women age and reach menopause.

HRT can be taken as estrogen only or as a combination of estrogen plus progestin (combined HRT). Combined HRT is most commonly used. Estrogen-only HRT can increase the risk of uterine cancer (cancer of the uterus), so it is usually only recommended for women who have had a hysterectomy to remove their uterus.

Taking estrogen alone can cause cancer in the lining of the uterus, but women who have had their uterus removed (hysterectomy) can take estrogen alone as they no longer have this cancer risk. Combined HRT is more commonly used by women with a uterus.

What are the benefits of HRT?

Combined HRT may help relieve menopausal symptoms, protect against osteoporosis (thinning of the bones) and reduce the risk of colon cancer.

What are the risks of HRT?

Research shows that long-term use of combined HRT (for 5 or more years) increases the risk of breast and ovarian cancer, heart disease, stroke and pulmonary embolism (blood clots in the lungs). The research suggests that the risks of long-term combined HRT use outweigh the benefits for most women.

The decision to take HRT is personal and should be made with the help of your doctor. Concerns about cancer, heart disease and stroke should be discussed when considering the benefits and risks of HRT.

Our recommendation

The Canadian Cancer Society recommends that women avoid taking HRT for any reason other than to relieve severe menopausal symptoms that have not responded to other treatment.

If you are thinking about taking HRT, talk to your doctor about the benefits and risks of taking it. These include:
• how severe your menopausal symptoms are
• your individual and family history of heart disease, breast and ovarian cancer, osteoporosis and dementia
• how long you will be taking HRT

If you and your doctor decide that taking HRT is right for you, the lowest effective dose should be used for the shortest period of time possible.

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