Hormone replacement therapy has been a really confusing topic for the past decade, with different studies offering conflicting information about its health benefits and consequences. Finally, the American Congress of Obstetricians and Gynecologists has revised its guidelines on treating the symptoms of menopause like hot flashes and vaginal atrophy (shudder).
Issued as a practice bulletin for doctors, the document gives guidelines for the proper management of menopausal symptoms—which affect three-fourths of women once their bodies stop producing estrogen.
Hormone replacement was a common practice for years as a treatment for the symptoms—like hot flashes and vaginal atrophy—and was also considered to prolong life and reduce incidences of dementia. However, in 2002 a widely-reported study found that a popular hormone pill increased a woman's risk of heart disease, breast cancer, stroke and blood clots. It scared off many women from hormone replacement treatment, and helped spawn an industry of alternative treatments.
The new guidelines help clear up the confusion. The ACOG advises that hormone replacement therapy be used, but consider transdermal (using a patch, gel, or spray) medication to be safer, since being absorbed through the skin means bypassing the liver, thus avoiding an increased risk of heart attack or cancer. However, the ACOG also recommends that hormone replacement therapy is not good for women over 65.
As far as alternative treatments go, the report said that low doses of antidepressants were helpful, as well as Clonidine (a blood pressure medication) and gabapentin (an anticonvulsant), though these have not been approved by the FDA for menopausal treatment. The report found "little to no data" supporting the use of herbal remedies, vitamins, soy, or acupuncture.