Pearl obstetrics | gynaecology

The benefits of HRT


Why HRT is beneficial

HRT is beneficial when started at the time of the menopause. The research that showed problems with HRT was in women in their 60s who already had medical problems. When started at the correct time, hormone replacement therapy cut deaths by 25% according to the research – people are afraid to use it because this wasn’t reported! Patches may be even better than tablets.

HRT is good for treating flushes, sweats and vaginal dryness. It prevents fractures and helps the discs in the spine. Oestrogen without or with testosterone helps some reproductive depression, energy and libido. There is evidence that it reduces heart attacks. HRT improves the texture of the skin & nails. There is a 1% extra lifetime risk of breast cancer. This should be balanced against the fewer heart attacks, fewer deaths and serious fractures in those who start HRT below the age of 60.

HRT will stop your hot flushes and sweats

Troublesome hot flushes, severe night sweats and headaches causing chronic insomnia are characteristic symptoms of the menopause. These symptoms may last for many years. Apart from being socially embarrassing they result in tiredness and depression because of lack of sleep. These symptoms can be cut by at least 75% with HRT. No other teatment is as good.

Oestrogens will treat vaginal dryness, painful intercourse and lack of libido

Thinning, vaginal dryness, and occasionally bleeding occurs after the menopause. This also can be successfully treated with HRT, or local oestrogen cream which is very mild.

HRT increases bone density and prevents fractures

HRT is the most effective way of increasing bone strength and preventing osteoporotic fractures even in low-risk women. Younger women with weak bones due to premature menopause, early removal of the ovaries or anorexia benefit even more from HRT.

HRT protects the intervertebral discs

HRT prevents collagen being lost from the intervertebral discs, thus maintaining their strength and function. These discs act as cushions of the spine, preventing a bending of the spine and a hump.

HRT reduces heart attacks

The 2002 WHI Study, showed an increase in heart attacks but looked at patients of the wrong age using HRT ie over 60s. Women below the age of 60 have fewer heart attacks. A Mirena used with oestrogen makes HRT even safer.

Oestrogens help depression in many women

There is no doubt that depression is helped in postmenopausal women who have been suffering from night sweats, insomnia or vaginal dryness, painful intercourse and marital problems in that most of these problems can be effectively treated and removed. Some younger perimenopausal women with depression that is hormone sensitive in the 2–3 years before menopause can do very well with HRT.

HRT improves libido

HRT improves libido by curing vaginal dryness, painful intercourse and improving sexual desire. Testosterone can also be helpful, but must be used carefully.

HRT improves the texture of the skin

After the menopause, women lose about 25% of their collagen – thin inelastic skin, brittle nails, loss of hair. Oestrogen therapy replaces the lost collagen in the skin and the bone. Its effect on the facial skin is a very obvious useful cosmetic effect.

‘Better person to live with’
Many women say that when estrogen therapy stops their depression, their loss of libido and their irritability, they become more agreeable people to live with. The depression, irritability, grumpiness and loss of energy and disinterest in sex can usually be improved considerably HRT.

HRT is safe

In women who started HRT below the age of 60 there were fewer heart attacks, fewer deaths & fewer fractures. The additional risk of breast cancer of 1% is no more than the breast cancer risk of being overweight or drinking wine.

We are experienced in all menopausal matters

Dr Sillender has a huge amount of experience in menopause medicine, having worked with and stood in for one of world’s foremost authority’s on HRT in his quaternary referral clinic in a London teaching hospital. You will need a referral from your GP if you would like a Medicare rebate, otherwise unsubsidised private fees apply. Our clinic is located near Fremantle & Applecross, a short drive from the Western Suburbs, so come and see us.

Dr. Mark Sillender. Consultant obstetrician & gynaecologist