For Women - Hormone therapy: Is it right for you?

Hormone therapy was once routinely used to treat menopausal symptoms and protect long-term health. Then large clinical trials showed health risks. What does this mean to you? By Mayo Clinic Staff

Hormone replacement therapy — medications containing female hormones to replace the ones the body no longer makes after menopause — used to be a standard treatment for women with hot flashes and other menopause symptoms. Hormone therapy (as it's now called) was also thought to have the long-term benefits of preventing heart disease and possibly dementia.

Use of hormone therapy changed abruptly when a large clinical trial found that the treatment actually posed more health risks than benefits for one type of hormone therapy, particularly when given to older postmenopausal women. As the concern about health hazards attributed to hormone therapy grew, doctors became less likely to prescribe it.

Hormone therapy is no longer recommended for disease prevention, such as heart disease or memory loss. However, further review of clinical trials and new evidence show that hormone therapy may be a good choice for certain women, depending on their risk factors. What are the benefits of hormone therapy?

The benefits of hormone therapy depend, in part, on whether you take systemic hormone therapy or low-dose vaginal preparations of estrogen.

Systemic hormone therapy. Systemic estrogen — which comes in pill, skin patch, gel, cream or spray form — remains the most effective treatment for relief of troublesome menopausal hot flashes and night sweats. Estrogen can also ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse.

Although the Food and Drug Administration (FDA) still approves estrogen for the prevention of the bone-thinning disease called osteoporosis, doctors usually recommend medications called bisphosphonates to treat osteoporosis. Low-dose vaginal products. Low-dose vaginal preparations of estrogen — which come in cream, tablet or ring form — can effectively treat vaginal symptoms and some urinary symptoms, while minimizing absorption into the body. Low-dose vaginal preparations do not help with hot flashes, night sweats or protection against osteoporosis. Long-term systemic hormone therapy for the prevention of postmenopausal conditions is no longer routinely recommended. But some data suggest that estrogen can decrease the risk of heart disease when taken early in postmenopausal years.

A recent, randomized, controlled clinical trial — the Kronos Early Estrogen Prevention Study (KEEPS) — explored estrogen use and heart disease in younger postmenopausal women. The study found no significant association between hormone therapy and heart disease.

For women who haven't had their uterus removed, estrogen is typically prescribed along with progesterone or progestin (progesterone-like medication). This is because estrogen alone, when not balanced by progesterone, can stimulate growth of the lining of the uterus, increasing the risk of uterine cancer. Women who have had their uterus removed (hysterectomy) don't need to take progestin. What are the risks of hormone therapy?

In the largest clinical trial to date, a combination estrogen-progestin pill (Prempro) increased the risk of certain serious conditions, including:

• Heart disease
• Stroke
• Blood clots
• Breast cancer

A related clinical trial evaluating estrogen alone (Premarin) in women who previously had a hysterectomy found no increased risk of breast cancer or heart disease. The risks of stroke and blood clots were similar to the combination therapy.

Hormone therapy, particularly estrogen combined with a progestin, can make your breasts look more dense on mammograms, making breast cancer more difficult to detect. Also, especially when taken for more than a few years, hormone therapy increases the risk of breast cancer, a finding confirmed in multiple studies of different hormone therapy combinations, not just limited to a combination estrogen-progestin pill (Prempro).

The risks of hormone therapy may vary depending on whether estrogen is given alone or with a progestin, and depending on your current age and age at menopause, the dose and type of estrogen, and other health risks such as your risks of heart and blood vessel (cardiovascular) disease, cancer risks and family medical history.

All of these risks should be considered in deciding whether hormone therapy might be an option for you. Who should consider hormone therapy?

Despite the health risks, systemic estrogen is still the most effective treatment for menopausal symptoms. The benefits of hormone therapy may outweigh the risks if you're healthy and:

Experience moderate to severe hot flashes or other menopausal symptoms Have lost bone mass and either can't tolerate or aren't benefitting from other treatments Stopped having periods before age 40 (premature menopause) or lost normal function of your ovaries before age 40 (premature ovarian insufficiency) Women who experience an early menopause, particularly those who had their ovaries removed and don't take estrogen therapy until at least age 45, have a higher risk of:

• Osteoporosis
• Coronary heart disease
• Earlier death
• Parkinsonism (Parkinson's-like symptoms)
• Anxiety or depression

Early menopause typically lowers the risk of most types of breast cancer. For women who reach menopause prematurely, the protective benefits of hormone therapy usually outweigh the risks.

Your age, type of menopause and time since menopause play a significant role in the risks associated with hormone therapy. Talk with your Blueprint Patient Care Coordinator about it.

Research and Markets: Global Hormone Replacement Therapy Market 2015-2019

DUBLIN--(BUSINESS WIRE)--Research and Markets (http://www.researchandmarkets.com/research/tvzh23/global_hormone) has announced the addition of the "Global Hormone Replacement Therapy Market 2015-2019" report to their offering.

The report presents the vendor landscape and a corresponding detailed analysis of the top vendors in the market, including F. Hoffmann-La Roche, Merck Serono, Novartis, Novo Nordisk, and Pfizer.

Hormone replacement therapy involves the replacement of the hormones in the body whose levels have become low, in case of women nearing menopause or patient with growth hormone deficiency due to conditions such as dwarfism. At present, the combination of drugs are used to treat the conditions, which are known to have a better safety and efficacy parameter. Unmet medical needs is one of the major drivers influencing the growth of the market. Therefore, the need for new treatment options with better safety results to accommodate the current unmet need is huge.

In 2014, the Americas dominated the market, where the majority of the contribution was from the US, and this trend is expected to continue during the forecast period. However, the market in the APAC region is witnessing a rapid growth, hence, there is a vast opportunity for vendors to venture into this region. Technavio expects the global hormone replacement therapy market to grow at a moderate rate, posting a CAGR of over 2% during the forecast period.

With a market share of more than 60% the estrogen replacement therapy segment dominate the hormone replacement therapy market. Estrogen replacement therapy is a type of therapy in which estrogen hormones are commonly used to treat the symptoms of menopause. It helps in the reduction of short-term changes of menopause such as hot flashes, disturbed sleep, and vaginal dryness.

Segmentation of the hormone replacement therapy market by route of administration

- Oral

- Parenteral

- Transdermal

Key questions answered in the report include

• What will the market size and the growth rate be in 2019?
• What are the key factors driving the global hormone replacement therapy market?
• What are the Key Market trends?impacting the growth of the global hormone replacement therapy market
• What are the challenges to market growth?
• Who are the key vendors in the global hormone replacement therapy market?
• What are the market opportunities and threats faced by the vendors in the global hormone replacement therapy market?
• What are the trending factors influencing the market shares of the Americas, EMEA, and APAC?
• What are the key outcomes of the five forces analysis of the global hormone replacement therapy market?
• For more information visit http://www.researchandmarkets.com/research/tvzh23/global_hormone

Contacts

Research and Markets Laura Wood, Senior Manager press@researchandmarkets.com For E.S.T Office Hours Call 1-917-300-0470 For U.S./CAN Toll Free Call 1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 U.S. Fax: 646-607-1907 Fax (outside U.S.): +353-1-481-1716 Sector: Pharmaceuticals

Fusing good taste and good nutrition

Fusing good taste and good nutrition Every spring, Harvard Medical School's Department of Continuing Education, The Osher Institute at Harvard Medical School, and The Culinary Institute of America present a special event called "Healthy Kitchens, Healthy Lives."

This four-day conference brings together doctors, dietitians, and health care professionals for an experience that combines the latest nutrition research with healthy cooking demonstrations and hands-on workshops.

Here are some practical tips for nutritious and delicious home-cooking from a recent Healthy Kitchens, Healthy Lives.

Make plants the main attraction

A substantial amount of research shows that people who eat a plant-based diet — mainly fruits, vegetables, whole grains, and legumes — live longer and enjoy better health than people whose diets consist mainly of animal-based foods like meat.

Many cultures developed their cuisines around plant foods out of necessity. Traditionally, animal protein was expensive, so limited quantities were available. Mediterranean, Latin American, and Asian cultures are known for pairing healthy plant foods with lean protein (fish, chicken) and monounsaturated fat (olive oils, nuts).

These diets can have substantial health benefits. For example, a Mediterranean-style diet has been found responsible for:

• longer life expectancy
• reduced heart disease
• relief from rheumatoid arthritis
•  lower rates of Parkinson's disease
•  lower rates of Alzheimer's disease

Here are three tips to get creative with your plant-based meals:

1. Follow the motto "If it grows together, it goes together." For example, try the Spanish sauce called romesco over grilled vegetables. It's made from roasted red peppers, olive oil, and nuts.
2. Make olive oil really shine by matching a bold olive oil, such as a Tuscan varietal, with other bold flavors, such as rosemary and pine nuts.
3. Complement a milder olive oil, such as a French varietal, with subtly flavored foods.

Eat locally

Locally grown foods may be fresher and have higher nutrient content. Since they spend less time being shipped and handled, they may look and taste better.

Spice it up

Despite the lack of research on their health benefits, spices, herbs, and aromatics (any plant, herb, or spice that adds lively scent to a beverage or food) make other plant foods mouth-watering treats. And they are definitely a healthier option than piling on the salt. Unlike salt, spices have not been linked to high blood pressure, heart disease, or stroke.

Here are four ways to ensure the quality and flavor of your spices:

1. Buy them in small quantities and in their whole form to ensure freshness.
2. Store them in a cool, dry space.
3. Grind them right before use.
4. Toast them dry in a hot skillet or stir-fry them in oil over medium-high heat (both for just 10-20 seconds).

Get excited about whole grains

Rich in fiber, vitamin E, and magnesium, whole grains (such as whole-wheat bread or pasta, or brown rice) are far better nutritionally than refined grains (such as white bread or white rice). And they make you feel fuller longer. Because the starch inside of them is absorbed more slowly, they're less likely than refined grains to quickly be stored as fat. Regular consumption of whole grains also reduces the risk of:

• diabetes
• cancer
• heart disease
• stroke
• diet-related depression (usually associated with very low-carbohydrate diets)

Here are five ways to incorporate different types of whole grains into your diet:

1. Use whole-grain bread, pasta, and brown or wild rice.
2. Try grains from around the world such as teff, spelt, farro, kamut, and amaranth.
3. Blend whole grains with colorful vegetables, spices, and olive oil.
4. Eat whole-grain cold or hot cereals, adding fruit, low-fat milk, or nuts.
5. Season whole grains with sweet spices like nutmeg, allspice, cardamom, and masala spice.

Go a little nuts

In a large trial of men and women, eating nuts five times a week or more lowered diabetes risk by 27%. In another large study, women who ate nuts just about every day lowered their risk of heart disease by 32%.

However, since a one-ounce portion of nuts can pack 160 calories or more, eat them in moderation to help prevent weight gain. Two tasty suggestions: toasted pine nuts sprinkled over whole-grain pasta, or almonds on cereal.

Following the above advice will not only make your meals nutritious, but will also allow you to enjoy some of the most delicious food you've ever eaten.