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Menopause

Guidelines for HRT

11/28/2007

Question:

What are the current guidelines for taking HRT? My sister`s doctor will not her take HRT because of calcifications in her breasts. There is a history of breast cancer in our family. At 53 I am still having regular periods but on my last GYN visit the doctor informed me that I would be taking HRT once I started to miss periods whether I am having hot flashes or not. I do not want you in a debate with my gyn, so was wondering what the official position was on HRT these days. Any advice will be appreciated.

Answer:

In general, hormone therapy was approved by the FDA (Food and Drug Administration - the federal agency that has to approve all prescription drugs) for the treatment of moderate to severe hot flashes and symptomatic vaginal dryness/irritation due to low estrogen levels. The major medical organizations that are related to the care of menopausal women have all recommended that hormone therapy be used for the same reasons in the lowest dose that treats the symptoms and for the shortest amount of time that meets the patient's needs.

The use of estrogen and progestogen has been associated with an increased risk of invasive breast cancer, but a family history of breast cancer and a history of calcifications in the breast are not contraindications to using hormone therapy.

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Response by:

Margery   Gass, MD Margery Gass, MD
Formely, Professor, Clinical Obstetrics & Gynecology
College of Medicine
University of Cincinnati