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Sept 5, 2003 Recent studies have renewed the decades-old debate about using hormone replacement therapy (HRT) on women going through menopause. Traditionally, HRT was prescribed to relieve the unpleasant and socially unacceptable symptoms of menopause. The most obvious of these are hot flashes. Hot flashes are not gentle waves of warmth. They are not power surges - which is a cute euphemism, but off the target completely. They are clothing-soaking, think-I'm-on-fire, sweating-like-a-boxer, ruined-my-presentation, gotta-go-change-now, life-interrupting experiences. There is no warning of them. There is no regularity to them. You can't plan to have a hot flash at a more convenient time. You can't take two aspirin to stave them off while you're pitching your proposal to the board of directors. Hot flashes are nearly disabling socially for many women. That's the bad news. This is also bad news. Extra estrogen can promote both breast cancer and uterine cancer. Many studies over the years have shown this. More recently, HRT has been linked to an increased risk of heart disease, contrary to earlier studies based upon theory that claimed a heart-protective effect of HRT. When HRT was first popularized in the 1960's, doctors hailed it as a way to "normalize" menopausal women, keeping them young and healthy decades longer than previously thought possible. No matter that these claims were not based upon science. No matter that estrogen and progesterone coursing through our veins was deemed more "normal" than the absence of these hormones, although most women live successfully without much estrogen or progesterone for decades after menopause. No matter that mostly aging white men made the decision about what is normal and what is not. Some elements of our society choose to suppress the real physiological function of the these hormones, which is to promote reproduction, in favor of the cosmetic functions such as perkier breasts and that certain glow that suggests the fecundity of youth. You may consult your own physician, but I can tell all by myself that these are not good reasons to take dangerous drugs. So what to do about hot flashes? Hmmm....perhaps one day we will live in a place where it's socially acceptable to have a hot flash during that board of directors presentation. A place where it's okay to - yes, call me crazy - breast feed in public, have a bit of a belly after you turn 40, and admit that you are experiencing menopause. Maybe inhabitants of this exotic new world will have learned that hot flashes are mercifully temporary, lasting months or perhaps a year or two. That they wax and wane in intensity over time. That not all women experience them during menopause. That no one has ever died of one. That embarrassing other people doesn't harm them permanently. And that the hearts, uteri, breasts and lives of aging women are worth the trouble. ------------ About the author: Teresa Tarnowski Goodell, RN, CNS, is a practicing clinical nurse specialist, clincal research consultant, and trauma-neurogical intensive care nurse with over 20 years' experience in health care. Email Teresa: t.goodell@comcast.net ------------ |
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