Controversial Women Health Issue Paper, HRT
The state of health has been quite a necessity in virtually all categories of populations and sex. In particular, women health with respect to maternal and puberty health has raised much concern in the recent past due to the various changes in both the environment and the body response to the latter. During the menopause, the woman experiences a decline in the production and release of the hormones namely: testosterone, estrogen and the progesterone. Menopause often comes about in the life of a woman at an average of 51 years of age. However, the process may occur earlier or later within an approximate of 10 years range, a condition known as the perimenopause and postmenopause respectively. The decline in the discharge of the hormones results in a state of discomfort to the respective women. The Hormone Replacement Therapy is therefore a case treatment that is aimed at alleviating the discomfort caused by the decline in the hormonal discharge resulting to certain discomfort. This paper therefore analyzes the controversy that arises in the use of the HRT as a treatment against menopause related discomforts (Turske, 2011).
The combination HRT often takes a positive perspective ion the sense that it is taken to reduce levels of hyperplasia and carcinogenic elements in the female bodies with non-controversial therapy of estrogen by use of three key hormones: progesterone, progestin and the estrogen. According to the report by Women’s Health Initiative from the National Institute of Health US (2002) and the Million Women Studies in UK, the mortality caused by HRT administration when started earlier (50-59) was relatively lower than one asked late in life. Indeed, the administration of HRT was intended to minimize the discomfort caused by the reduced levels of the three aforementioned hormones. However, the result indicates that older patients were at a high risk of contracting breast cancers, stroke as well as heart attacks.
However, the latter are at a lower risk of contracting colorectal cancer as well as bone fractures. As a result of these finding, there was a significant drop in the number of women accepting the administration of HRT as the risks of administration surpassed the benefits. As a result, the Initiative advocated that non-surgical menopause victims should take the lowest possible dosage of the HRT in order to cut down on the risks associated (Genazzani & International Menopause Society, 2006).
Despite the many risks associated, HRT remains a key treatment for the various menopausal ailments such as the urogenital atrophy and vasomotor hot inflammations as indicted from the findings of US food and Drug Administration. Indeed, the United States Preventative Task Force report, 2012 indicated that the risks of administration of the HRT exceed the benefits that the same has on the prevention of chronic infections. However, a controversial report from the Endocrine Society Publication indicates that early administration during perimenopause or early menopause, HRT accrues to a fewer risks and cut down on the cause mortality as observed in a vast number of patients. This was also seconded by the 2009 American Association of Clinical Endocrinology report that further approved the use of HRT in the treatment of menopause related defects. This therefore amounts to the highly controversial issue of the benefits versus risks in the administration of the Hormone Replacement Therapy (Babiera & Esteva, et al. 2012).
In essence, HRT has had a number of health effects that has seen the growth and rise in the controversial debate about the benefits versus the risks associated with the treatment. According to the reports from both cross-sectional and cohort examinations of UK, US and China, the reports indicates that the vast group of the affected cases were the women administered in post-menopause periods. While at it, the incidences of HRT administration and the hazardous effects of the same were indicatively realized most often in the older patients victimized of the HRT. Indeed, the hormone, progesterone is considered to be the main anabolic hormone responsible for the growth and maturity of the breast tissue and therefore, breast cancer recorded low in the victims under estrogen therapy alone in post-hysterectomy. This is because, the administration of estrogen alone is said to be contraindicated given that the uterus is present at the time of administration since it is proliferative effects regarding the endometrium. The World Health Initiatives (WHI) further indicated that mutual administration of both progesterone and estrogen results in reduced incidences of colorectal cancer as well as bone fractures (International Symposium on Special Aspects of Radiotherapy & Moser, 2008).
In the same sense, the benefits of HRT aims at minimizing the discomfort associated with the declining levels of both progesterone and estrogen hormones in circulation during menopause. Indeed, combination HRT is recommended for the patient with premature or artificially induced menopause. In essence, HRT in such instances is believed to be presumably a life prolonging agent while at the same time taken to have the ability to mitigate the woman’s chances of contracting endometrial cancers which is associated with the unimpeded estrogen therapy besides decreasing the contraction of dementia. This therefore accounts for the essentials of HRT despite the numerous side effects associated (Singh & New York Academy of Sciences, et al. 2005).
Furthermore, other studies have indicated that HRT also leads to the enhancement of the post-menopausal sexual dysfunctions. The change in hormonal physiology which in essence results from the menopause results in some physical problems such as desire deficiency coupled with low libido. Indeed, the HRT is also taken to have positive implication on the vaginal lubrication, sexual pains as well as orgasm. The administration of the estrogen for instance has been identified as a viable measure that helps thwart the formation of amyloid plaque and oxiadative stress which are key causative agents of etiology of Alzheimer’s infections. In practice there are several options upon which the women may be administered three of which are: administration of estrogen alone; estrogen and another progestins or the mutual combination of the androgens, estrogens and the progestins (Dennerstei & Shelley, 1998).
In the context of medical literature, Hormone Replacement Therapy is highly controversial particular on its impact on the cardio-vascular functioning. For instance, the reduction in the cardiovascular infection as reported in most of the observational observation has yet to be proved in the random clinical trials. For instance, the rise in risks with respect to cardiovascular infections as reported in the WHI report impartial and finely spread out since it was mostly in old women and late starters of HRT. Furthermore, the rise in the risks of contracting coronary heart infections during the treatment arm research arm showed a varying trend across all ages from the beginning of menopause. Indeed, the number of women between the 50-59 age brackets with the HRT administration portrayed a lower risk of contraction of coronary heart infections relative to the group that did not. However, this may not be the effect on the cardiovascular tissues with the oral dosage of HRT’s progestin as well as the equine estrogens via the process of Oral Systemic Therapy. This is due to the absence of the hepatic vitamin K dependent which is the clotting agent. Further analysis also revealed that the HRT is capable of reducing the development of heart infections younger women as opposed to old age (60 and above). This is due to the contradictory effect on raising the clotting profile while at the same time reducing positively affecting the lipid profile of the body but the findings remains unconfirmed (Genazzani, 2003).
Further in this analysis, the HRT also carries an impact on the endometrium. The patients of endometrial tumor with the administration of HRT have a lower mortality risk than HRT victims. The combined estrogen-progesterone HRT has been long linked with causation of endometrial cancer. However, there are specific subtypes of the combination with extremely low mortality and morbidity. The unimpeded estrogen may also result in the contraction of a condition of endometrial hyperplasia which is deemed to precede endometrial cancer. Indeed, the excessive dosage of the estrogen as a means of birth control in 1970s for instance is contemplated to have been the cause of the rising incidences of endometrial cancer in US. The HRT therefore remains a potential source of cancer and therefore ought to be sparingly used as treatment for the menopause-related discomforts as the risks of use surpasses the benefits as brought out earlier in this paper.
Finally, in this context, the administration of the HRT has been one of the most refuted therapeutic controls of various ailments. However, despite the well thought of advantages of use, the treatment has also been believed to have profound effect on the various functioning of the body. The particulate point of controversy is in the early administration versus late administration with respect to commencement of menopause. HRT has been taken to be quite effective when administered in the early period prior to the commencement of menopause between 50 and 59 years of age.
Essentially, early administration has been found out to be a viable preventative measure against cancerous as well as stroke a infection which reduces the mortality rates for the HRT victims. On the other hand, late administration of the treatment may have minimal or zero effects on the users particularly beyond 60 years of age. Additionally, HRT is deemed to have positive implications on the users if administered to users attributable to early menopause or the artificially instigated menopause. Other than the numerous benefits attributed with the treatment, the administration is coupled with a pool of challenges since it is also attributable to raising the risk of contracting some specific types of cancers such as the endometrial cancers among others.