A life-changing experience: menopause and hormone replacement

As a physician, I am often reminded that life indeed is a question of timing. When to intervene and when not to intervene is a common dilemma when dealing with the human body. On a scientific level, the question can be posed constantly. When is the right time to prevent a disease.

As human beings continue to evolve and as medicine continues to advance I believe this question will become ever more prevalent in our health care paradigm.

When faced with the treatment disease we much continuously ask when is the point of no return and when is the turning point.

Such is indeed the case with many of lifes natural aging processes. Remember not all bodily malfunctions are diseases. Sometimes the body just ages as a natural function of the process itself.

And by this, I mean menopause.

The issue comes down, again to one of timing. A volume of population data shows that a womans risk of cardiovascular disease begins to rise after she goes through menopause. This epidemiological data prompted a variety of theories on the cardio protective effects of estrogen and progesterone.

Hormone replacement therapy

Hormone replacement therapy made its therapeutic debut in the 1960s for the treatment of symptoms of menopause. Women with vasomotor symptoms (hot flashes, sleep disturbance, palpitations) and mood disorders were offered an option.

For much of the 1990s there was an assumption that indeed hormone replacement therapy (HRT) decreased a womans risk of cardiovascular disease.

And then came the Womens Health Initiative (WHI). The WHI was a set of clinical trials first launched in 1991 that was designed to look at effects of hormone replacement therapy on cardiovascular disease and osteoporosis in postmenopausal women. The study was randomized, meaning half the patients in the study randomly were chosen for treatment and half received placebo.

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A life-changing experience: menopause and hormone replacement