Thyroid Function and Hormone Replacement Therapy: A Guide for Women

The transition to menopause can be a trying time for many women. Although the term "menopause" technically refers to the cessation of the monthly menstrual period and the decline of fertility, this change ushers in an array of other health challenges.

As many thyroid patients already know, even a slight fluctuation in hormone levels can pose a threat to one's overall health and well-being. The sometimes-dramatic decline in estrogen production that accompanies the onset of menopause can cause a number of difficult symptoms, as well as putting women at higher risk for a broad spectrum of illnesses and injuries.

In order to ease the transition to menopause and reduce the health problems associated with declining estrogen levels, the practice of prescribing synthetic hormones to replace the estrogen produced naturally by the body became popular in the 1990s. However, despite the efficacy and popularity of this treatment, it has garnered some negative attention after studies indicated a link to higher risks of conditions such as breast cancer, stroke, and heart disease.

Thyroid patients who are thinking about hormone replacement therapy have other considerations to mull over, as well. Because thyroid disorders can create havoc in the endocrine system, which produces and distributes hormones in the body, they face unique risks when undergoing hormone replacement therapy.

This week, we'll take a look at the positive and negative effects, the pros and cons, of hormone replacement therapy for thyroid patients.

A Sudden Change in Protocol

Because women with thyroid disorders are often at higher risk for heart disease, it was long thought to be advantageous to use hormone replacement therapy to reduce this risk as thyroid patients approached menopause. However, the safety of this treatment was thrown into question when the results of a landmark study were released in 2002.

A large-scale investigation conducted by the U.S. National Heart, Lung, and Blood Institute found that the pill forms of hormone replacement therapy were not as safe as previously thought. Indeed, among women who took the most popular hormone replacement pills, the risk of many serious health disorders was shown to be significantly higher.

The negative outcomes noted in the experiment included conditions such as pulmonary embolisms, invasive breast cancer, stroke, and heart disease. Although some positive health benefits were associated with the hormone replacement therapy -- in addition to alleviating menopause symptoms, the drugs also proved to be protective against colon cancer and weakened bones -- the scientists determined that the total risks outweighed the positive aspects. Indeed, so great was the level of perceived risks that the massive study was halted mid-way.

With these dramatic findings, the longstanding practice of treating menopausal thyroid patients with hormone replacement therapy as a measure of protection against cardiovascular problems was suddenly called into question. Although pill-based hormone replacement therapy continues to be prescribed for some thyroid patients, it is generally no longer recommended for long-term use. Most experts agree that the continued need for hormone replacement therapy should be re-evaluated on a case-by-case every three to six months.

What Can You Do?

If you're a menopausal woman who is also treated for a thyroid disorder, you have several options for hormone replacement therapy. As discussed previously, you could opt for short-term use of conventional, pill-based hormone replacement medication. This type of treatment usually involves using the therapy sporadically as menopausal symptoms occur. In this scenario, you would consult with your physician frequently to make sure that your treatment is used only as long as the symptoms demand it.

Some women have opted to use soy-based estrogen treatments rather than synthetic hormones. While this option has proven effective against a number of the most common menopausal symptoms, it might not be advised for women with hypothyroidism. This is because soy products are believed to inhibit thyroid function in some patients. Additionally, some reports have indicated that soy intake may block the absorption of thyroid medication.

Many thyroid patients have sought out alternative therapies to help ease symptoms of menopause. Consulting with an osteopath, naturopath, or another qualified holistic healthcare provider will help you achieve a better understanding of available treatments and their safety and effectiveness.

If you're concerned about weathering the challenges and changes of menopause while maintaining healthy thyroid function, talk to your doctor to develop a comprehensive plan for treatment and prevention. Be sure to check back each week for more thyroid health news.

For Further Reading

• http://www.womenshealthlondon.org.uk/leaflets/hrt/hrt.html

• http://thyroid.about.com/library/news/blhrt.htm

• http://www.suite101.com/article.cfm/graves_disease/87816