Is Hormone Replacement Therapy Risky

Hormone Replacement Therapy
Hormone replacement therapy (HRT) has strengths and limitations, risks and benefits—however, it really depends on the individual patient as to whether this approach to health and healing is suitable or not. Some patients will be more open to accepting the limitations of a particular treatment while being satisfied with the benefits; others will be turned off by the risks of the treatment and want to seek an alternative care option or intervention that is more naturalistic. Both options should be appreciated and the nurse should not try to force a patient to accept one over the other. The position that the nurse should take is to give the patient all the information needed to make an informed decision that works for the patient. In this case, the nurse’s approach should be to provide the patient with data that is based on evidence and that is easy to understand so that the patient is not making a decision based on emotion but rather on the relevant information that applies to their health situation.
One of the strengths of hormone replacement therapy is that it can help to reduce the risk of other issues setting in—particularly in the case of menopause wherein women are at risk of getting osteoporosis. HRT can be a way for patients to offset this risk while keeping the body balanced. This strength and benefit might appeal to certain patients, though there are also risks of HRT that should be described, such as its side effects on sexual function, which might make patients reconsider (Johansen, Liavaag, Tanbo, Dahl, Pripp & Michelsen, 2016).
I personally would not be opposed to supporting HRT as it has been shown to be effective in a range of treatments and cases (Lobo, 2017). Some of these benefits include: “a reduction in coronary heart disease (CHD) and mortality” demonstrated from early clinical trials and “reductions in CHD and mortality when HRT is initiated soon after menopause” shown from newer studies, as well as data that now shows that HRT “significantly decreases the incidence of various symptoms of menopause and the risk of osteoporotic fractures, and improves quality of life” (Lobo, 2017, p. 220). For these reasons, I would be willing to prescribe supplemental hormones to patients interested in this approach. At the same time, I would fully respect a patient’s desire to go an alternate route, such as a homeopathic route and use natural herbs or other interventions to help the body cope with transformations, depending on the severity of the case and what the patient is most comfortable with doing. From a medical point of view, my belief would be based on the empirical evidence, such as that provided by Lobo (2017) and I would want to convey this evidence to the patient so that the patient can make an informed decision and not be relying on me to make that decision for them. Presenting the facts is one thing but deciding for each individual patient what would work best with their personal feelings and world view and situation in their own life is another and no nurse should really be taking that step.
In conclusion, my opinion is that nurses should be full of the latest information that can be passed on to patients so that they know the risks and benefits of a treatment like HRT. The nurse should not allow bias to enter into the communication of this information: be plain—identify the risks and benefits, the strengths and limitations. But also be aware that every patient is different; some will respond one way to certain ideas while others will respond a different way. There is no one right treatment approach for all patients—even if something like HRT has been shown to work overall, there are still some risks that would not be suitable to all patients.
References
Johansen, N., Liavaag, A. H., Tanbo, T. G., Dahl, A. A., Pripp, A. H., & Michelsen, T.
M. (2016). Sexual activity and functioning after risk-reducing salpingo-oophorectomy: Impact of hormone replacement therapy. Gynecologic Oncology, 140(1), 101-106.
Lobo, R. A. (2017). Hormone-replacement therapy: current thinking. Nature Reviews
Endocrinology, 13(4), 220.