What are the cons of hormone treatment for women facing early menopause?

The most commonly prescribed treatment for women undergoing early menopause is hormone therapy. It is important to bear in mind that the women's health initiative (WHI) studied the effects of hormone therapy on women fifty to seventy nine years old. The consequences of this therapy are not known for younger women who undergo surgical or treatment induced menopause or premature ovarian failure.

The WHI recommendations focus on the "routine" use of these therapies; early menopause, particularly through surgery, is arguably not routine. In fact, the benefits of hormone therapy for women under forty may well exceed the risks. For younger women, hormone therapy can actually be a replacement for what they have lost prematurely.

This is particularly true for women who have had their ovaries removed. Following natural menopause, the ovaries continue to produce low levels of hormones (including estrogen, progesterone, and testosterone). While your body has other minor sources of hormone production, if your ovaries are removed, this major source is gone.

Even before the announcement of the Women's Health Initiative results, younger women who experienced early natural menopause or had their ovaries removed were much more likely to fill prescriptions for hormone therapy than women who underwent natural menopause at the average age. The problems associated with surgically induced menopause, treatment-induced menopause, and early natural menopause are often more abrupt, severe, and frequent than those of natural menopause. In addition, you are at greater risk for many long-term health problems.

Your assessment of whether to start or continue hormone treatment should center on whether the benefits exceed the risks for you as an individual. This assessment should be reviewed regularly in light of new information. Alternative medical therapies for osteoporosis, like bisphosphonates, may be more appropriate for you than hormone treatment.

It is particularly important to discuss your situation with a health care provider who has extensive experience with early menopause as well as to familiarize yourself with the most current studies.

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