DEAR DR. GOTT:
I am 72 years old. I had a hysterectomy in 1983 and have been on hormone replacement therapy (HRT) almost since then.
I have read many articles lately about the dangers of HRT, both long- and short-term. However, my primary care physician is adamant that the benefits outweigh the dangers and he continues to prescribe them for me. I respect and trust this physician and have been his patient for more than 40 years, but given the fact that my sister had a double mastectomy (of which he has been made aware), I wonder if continued use of the hormone is safe for me.
I would appreciate your thoughts on this matter. Thank you in advance for any comments you may make.
DEAR READER:
I must congratulate you on the research you have done, as you are extremely well informed.
Levels of female hormones can vary before and during menopause and can result in hot flashes and vaginal dryness. HRT is prescribed to lessen or substantially reduce those unwanted symptoms. Therapy should be prescribed in the lowest possible dose for the shortest possible time to accomplish this. On the positive side, I must state that HRT may protect a woman against osteoporosis.
On the down side, however, it can increase the risk of breast cancer, stroke and heart disease. Certain types of HRT present a higher risk and each woman’s personal risk will vary, depending on lifestyle and family history.
You have a sister who underwent double mastectomy. I don’t know of a stronger family tie than that. In my opinion, you have been on HRT far too long. I am sure all symptoms of menopause have passed at this stage. If vaginal dryness is a concern, there are over-the-counter medicines available. If osteoporosis is a concern, add calcium-rich vegetables to your daily diet, or take calcium supplements.
You have a legitimate and legal right to advise your physician you are stopping the medication. Were I you, I would have done so a long time ago. However, giving him the benefit of the doubt, you might get a second opinion from another physician. In this way, you might feel more comfortable in going against his recommendations. If the action causes ill feelings with your long-standing physician, so be it. In my opinion, he’s wrong. He could have taken you off the medication more than 20 years ago, if even for only a trial period. He didn’t.
We are often fearful of angering a physician or someone of authority. What isn’t taken into concern is that you have only one body and, as long as you are in a proper frame of mind (which you certainly appear to be), you have every right to be in complete charge of it. Take a firm stand, advise him of your wishes, and be sure to stick to your guns. Enough is enough.
To give you related information, I am sending you a copy of my Health Report “Consumer Tips on Medicines”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.
About Dr. Gott