HRT And Stroke: Chest, Heart & Stroke Scotland

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Hormone Replacement Therapy And Stroke

What Is Hormone Replacement Therapy?

As the name suggests hormone replacement therapy (HRT) replaces hormones that have become diminished or lost during the female menopause. Replacing the hormone oestrogen has been found to ease some of the symptoms of menopause.

Symptoms include

hot flushes
night sweats
mood changes e.g. anxiety, irritability, depression
changes to the vaginal and genital skin e.g. dryness

HRT can be provided in the form of

pills
skin-patches
gel
nasal spray
implants which are put under the skin

What Are The Benefits Of Taking HRT?

The additional benefits of taking HRT are the protective effect against osteoporosis and bowel cancer. However, the protective effect is small. Studies have shown that if 1,000 healthy women who take HRT are compared to 1,000 healthy women who do not take HRT, in those who take HRT, over a 10 year period there will be about

5 fewer women who develop a hip fracture. This is because you are less likely to develop osteoporosis, and therefore less likely to fracture a bone.
6 fewer women who develop cancer of the bowel. It is not clear how HRT reduces the risk of developing this cancer.

Should I Take HRT After Having A Stroke?

Current research shows that HRT can slightly increase your risk of having another stroke.

If you were on HRT before having a stroke, you should discuss whether or not to continue treatment with your doctor, who will consider the risks and benefits to you on an individual basis.

What Are The Risks Of Taking HRT?

Research has shown that if you take HRT, you have a small but increased risk of developing a serious illness such as

stroke
heart disease
a blood clot. This can cause a DVT (deep vein thrombosis) in the legs or PE (pulmonary embolism) in the lungs
breast cancer
ovarian and womb cancer
dementia

What Are The Alternatives?

If you feel you need help to cope with your menopausal symptoms, you should discuss this with your GP. There are other measures that can help to ease the menopausal symptoms you are experiencing.

For hot flushes and night sweats

keep cool—have lukewarm baths or showers, wear cotton next to your skin, and sleep in a cool room
cut back on hot drinks, alcohol and spicy foods
take soya in your diet, in the form of tofu and soya milk
you can buy herbal supplements in health food shops, which help to reduce menopausal symptoms
many women find evening primrose and vitamin E relieve symptoms
your GP can prescribe non-hormonal medications such as Venlafaxine or Clonidine

For vaginal dryness

use aqueous cream rather than soap for washing
lubricants make sexual intercourse easier (e.g. KY Jelly or Replens)
your GP can prescribe oestrogen creams or pessaries

To prevent osteoporosis

increase the calcium in your diet by drinking a pint of skimmed or semi-skimmed milk a day, plus eating 60g (2oz) hard cheese such as Cheddar or Edam, or one pot of low-fat yoghurt (125g), or 60g of sardines
take regular weight-bearing exercise
your GP can prescribe additional calcium with vitamin D and other bone-restoring medication if you are at high risk of osteoporosis

What Else Can I Do To Help Myself?

Look after your general health

Stop Smoking
Eat Healthily—a well-balanced diet with at least 5 servings of fruit and vegetables per day
Control Weight
Keep Active
ensure you get enough sleep
avoid stress where possible
Control High Blood Pressure

Complementary therapies may also be helpful such as