Week 9 Discussion: Hormone Replacement Therapy

Week 9 Discussion: Hormone Replacement Therapy

Week 9 Discussion: Hormone Replacement Therapy

Ms. Martin is a 55-year-old woman who has been on HRT for 4 years. HRT was prescribed because Ms. Martin was experiencing vasomotor symptoms associated with menopause. Her last mammogram was 2 years ago and last pap was 5 years ago. Ms. Martin made an appointment with her nurse practitioner to discuss discontinuing HRT after hearing and reading news reports about the dangers associated with the medication. Except for the HRT, Ms. Martin is taking no medication other than a daily vitamin. She had a tubal ligation after the birth of her third child but has had no other surgeries or history of any medical conditions. Her father had cardiovascular disease and died of a myocardial infarction at 77 years of age. Her mother was diagnosed with breast cancer at 81 years of age. Ms. Martin does not smoke and rarely drinks alcohol. She likes to work in her garden but is not involved in a formal exercise program. She has gained about 10 pounds since menopause.

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What evidence-based information will you provide to Ms. Martin regarding her concerns of HRT? Discuss the advantages and risks associated with HRT.
What are your recommendations for Ms. Martin? Will you recommend continuing or discontinuing HRT and why?
What alternative treatments for menopausal symptoms will you discuss with Ms. Martin?
Discuss the recommended screening tests, using the latest evidence based guidelines that Ms. Martin should have.
What health promotion, maintenance, and prevention education would be important to provide to Ms. Martin?

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Week 9 Discussion: Hormone Replacement Therapy

1. What evidence-based information will you provide to Ms. Martin regarding her concerns about HRT? Discuss the advantages and risks associated with HRT.

Hormonal replacement therapy (HRT) is a common approach for alleviating menopausal symptoms. However, the effectiveness of this approach is a topic of debate considering the interplay between advantages and risks. According to Cleveland Clinic (2021), the major advantages of HRT include the alleviation of hot flashes, vaginal dryness, insomnia, mild depression, and irritability. Also, this procedure can boost hormone levels, including estrogen and progestin. However, hormonal replacement therapy (HRT) exacerbates various risks, including an increased risk of endometrial cancer, blood clot, dementia, breast cancer, gallstone problems, and stroke.

What are your recommendations for Ms. Martin? Will you recommend continuing or discontinuing HRT and why?

I would recommend the cessation of hormonal replacement therapy because of Ms. Martin’s age and the increased risk of negative ramifications associated with the therapy. According to Palacios et al. (2019), international guidelines recommend the commencement of HRT as soon as the first manifestation of menopausal signs or symptoms appears between 45 and 55 years. Ms. Martin is already 55 years and has been on HRT for 4 years. Equally, she is susceptible to cardiovascular conditions like myocardial infarction and cancer based on her family history. Also, she has gained 10 pounds since menopause, indicating an exacerbated risk for negative consequences of HRT. As a result, it is essential to discontinue the therapy.

What alternative treatment for menopausal symptoms will you discuss with Ms. Martin?

Although hormone replacement therapy (HRT) is the most common treatment for menopausal symptoms, its associated risks present a significant health concern. As a result, it is essential to discuss alternative treatments with relatively lower health risks. Johnson et al. (2019) recommend two broad categories of treatment interventions: mind-body practices (hypnosis, cognitive behavioral therapy, relaxation, aromatherapy, and meditation) and natural products (vitamin D supplements and minerals). Other potential treatment interventions include acupuncture, homeopathy, and reflexology.

Discuss the recommended screening tests, using the latest evidence-based guidelines that Ms. Martin should have.

I would recommend different types of screening to assess Ms. Martin’s propensity to the adverse effects of prolonged use of hormonal replacement therapy (HRT). These screening tests include the prothrombin time (PT) test for screening blood clotting status, a pap examination every five years to screen precancers, including cell changes on the cervix, and a fibrinogen blood test. Finally, it would be essential to frequently screen Ms. Martin’s mental health status to prevent issues like depression associated with menopausal symptoms.

What health promotion, maintenance, and prevention education would be important to provide to Ms. Martin?

First, it is essential to educate her about the need to discontinue hormone replacement therapy based on the potential exacerbation of the risk of adverse consequences. Secondly, healthcare professionals should provide information regarding the available treatment alternatives for menopausal symptoms, including Vitamin D and mineral supplements. Equally, it is crucial to enlighten Ms. Martin on various preventive and self-management mechanisms, including cardiovascular disease (CVD) prevention, stress management, and cancer prevention. Finally, healthcare professionals should develop a follow-up plan and ensure care coordination to guarantee adherence to screening tests and non-pharmacologic approaches, such as physical exercise.

References

Cleveland Clinic. (2021, June 28). Hormone therapy for menopause: Types, benefits & risks. https://my.clevelandclinic.org/health/treatments/15245-hormone-therapy-for-menopause-symptoms

Johnson, A., Roberts, L., & Elkins, G. (2019). Complementary and alternative medicine for menopause. Journal of Evidence-Based Integrative Medicine, 24(24), 1–14. https://doi.org/10.1177/2515690×19829380

Palacios, S., Stevenson, J. C., Schaudig, K., Lukasiewicz, M., & Graziottin, A. (2019). Hormone therapy for first-line management of menopausal symptoms: Practical recommendations. Women’s Health, 15. https://doi.org/10.1177/1745506519864009