Dr. Subir Roy, MD, specialist in women healthcare areas and winner of Squibbs award and Presidents award, Society for Gynaecologic surgeons and an eminent professor gave a specialist speech in Bangalore on 12th February, 2001 to leading city Gynaecologists and threw light on various research being done for better understanding, changes in treatment of menopause and new benefits. He highlighted the concluding current evidences that clearly indicate a number of benefits for postmenopausal women without any major risk from Hormone Replacement Therapy.
      Women generally enter the menopausal period after the age of 50. Though women in early years of menopause suffer more from hot flushes, insomnia, irritability and mood disturbances, in the intermediate stages the sufferings are more because of vaginal atrophy, urinary incontinence & skin atrophy. However at the later stages it is the osteoporosis, cardiovascular diseases, Alzheimer's disease, dementia & cancers that become an issue. Hormone Replacement Therapy (HRT) brings about significant improvement in quality of life by reducing/improving almost all aspects of the clinical changes in postmenopausal women.
      Dr. Subir Roy points out " the epidemiological data of United States indicates that the mortality rate is highest because of cardiovascular diseases and strokes. The mortality rate for cancers including lung, breast, colon & endometrium is far below."
      He explained through another study showing the reasons for hospitalisation in USA that the heart diseases & fractures dramatically increase in women beyond 65 years. However, the increase in all types of cancers is comparatively much lower.
     
      Generally, the postmenopausal women believe that estrogens add to their body weight.
      However studies have shown that without estrogens, women tend to gain more weight at the mid section, whereas with estrogens women tend to be slimmer & tend to have less central weight gain. Yet another misconception in the minds of women is regarding breast cancer. One of the surveys in U.S. revealed that though 40% of the women perceived that that the leading cause of death was breast cancer where the actual deaths due to breast cancer in U.S. women was only 4%. This misinformation is either due to improper interpretation of data or a great hype on poor quality of evidence.
      Studies have shown that estrogens may not be the cause of breast cancer but are only unmasking it. The breast cancers unmasked by estrogens are manageable & there are very few mortalities due to it. Possibility of eudiometrical carcinomas due to unopposed estrogen can be easily reversed by the addition of progestrogens.
      Keeping in view the fact that estrogens benefit almost every clinical change in the post menopausal women and the risks of ERT i.e. breast carcinoma & eudiometrical carcinoma are viewed in correct perspective, the benefits provided by HRT far outweigh the possible risks.