Why Is HRT Prescribed For Menopausal Women

Why Is hormone-replacement therapy Prescribed For Menopausal WomenThis talk to answer the research question (Why hormone-replacement therapy is prescribed for menopausal women despite the risk of dresser cancer?) was carried out as mentioned in the methodology section using the literature review methodology. The selected studies were appraised with the life-sustaining appraisal tools by the Public health resource Unit. The methodology of literature review had well support to review all the studies in the perspective of the opposite and divulge meaningful evidence and information which in a single study capacity would have been otherwise unnoticed. The Critical appraisal tools have assisted to review all the studies comprehensively to ensure there validity, reliability and applicability so that the result could be generalized to all the menopausal women population. The studies which have been reviewed were conducted in various settings with participants from all types of study population hence the results are a whole few reunion of the existing predisposing factors with the associated risk of hormone-replacement therapy in the incidence of breast cancer.ANSWER TO THE RESEARCH QUESTIONEvery doctor has the relief of the patient of utmost importance while prescribing a treatment and every treatment is meant to trifle relief. And treatment has dose schedules, administration guidelines and perhaps side-effects which are generally explained by the doctor. But unlike other medicines there is a lot of unrest nigh the practice session of HRT though the associated risk when evaluated with other factors is not high.Keeping the results and conclusions derived from these studies in the present and elements for further research in front, it is seen that HRT does have benefits.These associated benefits with subprogram of HRT according to this study are1) Use of HRT decreases the risk of death overall (Sellers et.al,1997) (Sener et.al, 2009) and is associated with r ecurrence, metastasis-free survival and better overall and disease-free survival than HRT nonusers in the univariate analysis irrespective of the start of menopause (Sener et.al , 2009) (Bonneir et.al, 1998)2) HRT does not maturation the risk of breast cancer when administered to women for whom other risk factors have been excluded (Tzingounis et.al, 1996).2) There is an reverse relationship between HRT and mortality due to coronary heart disease, stroke and cancers other than breast (Sellers et.al, 1997)4) Use of HRT gives fewer locally mod cancers and smaller and better-differentiated cancers compared to non-users (Bonneir et.al, 1998).5) HRT is a favourable prognostic factor for breast cancer. (Bonneir et.al, 1998)6) Use of HRT counteracts the change magnitude incidence of breast cancer with the lower incidence of other tumors. (Olsson et.al, 2001)7) Long term HRT use has a favorable effect over against colorectal and endometrial cancer. (Writing Group for the Womens Health Initiative Investigators, 2002) (Corrao et.al, 2008).8) Use of trans-dermal HRT compared to the oral use of HRT is associated with lesser risk of breast cancer (Million women study collaborators, 2003) (Corrao et.al, 2008) which is presumed by the WHI, 2002.However these benefits depend on many other inter-connected factors of time of use, age of the menopausal woman, past personal history of HRT used, family history related to breast cancer, dose of the HRT administered and type of HRT regime prescribed.These aforesaid(prenominal) factors affect the element of risk as well in the following way.1) Risk of breast cancer may be increased with HRT use for duration of 5 years or less in women with family history of breast cancer (Sellers et.al,1997) (Olsson et.al, 2001).2) Increased risk of breast cancer after elongated use of HRT (Olsson et.al, 2001) (Sellers et.al, 1997) (Corrao et.al, 2008) (Sellers et.al, 1997) (Olsson et.al, 2001). This risk increased with increasing duration of use and decreased with time and r distributivelyed at baseline with 5 years time. (Ewertz et.al, 2005) (Million women study collaborators, 2003)3) high risk in current users than in past users which was greater for combined therapy than for other oral types of HRT (Million women study collaborators, 2003).4) Women who used combined estrogen and progestogen HRT regime are at increased risk of breast cancer (Stahlberg et.al, 2004) (Million women study collaborators, 2003) and Oral HRT use for long term had a higher risk of breast cancer than trans-dermal use of HRT (Corrao et.al, 2008).5) Increased risk of breast cancer with current use of HRT in women of 50 years of age and above which increased with increased use. No increased risk in women between the ages of 40-49 (Ewertz et.al, 2005) (Million women study collaborators, 2003).6) The risk of breast cancer increased in women who were current HRT users and had used OC in the past. (Lund et.al, 2007)7) HRT users developed breast can cer at a younger age than non HRT users (Sener et.al, 2009). check to the synopsis of the issues and factors derived it can be concluded that there are benefits associated with use of HRT which mutually depend on the risk factors. And this is the reason why HRT is prescribed for menopausal women despite the risk of breast cancer. And these will again depend on gynaecologist sound judgement and patients level of knowledge and awareness (2006).RECOMMENDATIONSTo ingest the optimal benefit with minimally associated risk, HRT could be prescribed to menopausal women for lesser duration which the studies present as 5 years. This duration which could be problematic and the age of the women also has to be considered with the link of different effects of HRT in different age groups would again depend on the individual gynecologists judgment and the patients compliance for regular follow up and mammographic screening.An attempt has been made to clear the otherwise existing dilemma of presc ribing HRT or not but this again depends on many other factors which are most importantly the patients follow up and the doctors perception of the associated prescribing strategies. However more research is needed as in spite of appearance the limitations of this dissertation though it is possible to conclude that there are benefits associated with the use of HRT despite the risk of breast cancer it is not possible to fruitcake out an effective prescribing strategy. And to bring any considerable changes a prescribing strategy and better patient compliance for follow-up would be needed.LESSONS LEARNTThese total results, conclusions and opinions from the studies have presented close to principle elements which could guide through the dilemma of prescribing HRT to yet another menopausal woman.1) It is evident that duration has a role to play in the increase of the foresaid risk of breast cancer and that there is no risk with the use of HRT in the past.2) A lot would also depend on t he gynecologist or the physicians prescribing principles. It would be needed by them to follow some guiding factors like evaluating high-risk and low-risk women, family history and previous history of Oral Contraceptives which would vary for each patient.3) A regular follow-up and timely check up as mentioned would financial aid to catch otherwise unnoticeable breast changes.4) Another factor which needs to be pursued for future research and studies is the type of HRT regimes. In routine HRT is prescribed orally hence less is known nearly other methods of administration which could perhaps assist in reducing the risk.5) It would also be helpful to find if there is a link with the BMI and use of HRT. primarily obesity is linked to many diseases and unhealthy conditions and this would help to categorize women into high or low risk group.This dissertation has tried to bring up some associating factors which could help to extract the optimal benefits with lesser risk. This systemati c approach has helped conduct this dissertation so as to answer the research question. However research in healthcare is never ending and is expanding every day (Aveyard, 2010). New studies with various designs are being conducted around this topic as I write my dissertation which will bring in more new opinions and evidences which will form base for yet another dissertation or study tomorrow to help develop a successful prescribing strategy.