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Which Women Are the Best Candidates for Hormone Replacement Therapy? Part 1; Biomarkers.


Over the years, Hormone Replacement Therapy (HRT) has been the target of a very heated debate. Although many doctors, gynecologists, and specialists insist that bio-identical hormones (hormones derived from natural sources like plant leaves) are safer than their previous versions, there are still many who insist HRT is dangerous to use.  One of the reasons this debate continues is because we are finding that some women respond better to HRT than others, and it’s safe to prescribe HRT to many women, but it’s not as safe for others.  A recent article published in April of 2015 by JoAnn E. Manson, MD, DrPH, discusses factors that help determine who is the best fit for Hormone Replacement Therapy (HRT) and who is not. Dr. Manson says, “We know that one size does not fit all, and some but not all women are good candidates for hormone therapy (1).”

The purpose of prescribing medication is to alleviate symptoms while minimizing the risk of side-effects. When it comes to prescribing HRT we are hoping to alleviate hot flashes, night sweats, sleep problems, mood changes, and all the annoying symptoms that can come with menopause.  But if doctors are prescribing Hormone Replacement Therapy to the wrong women and are putting them at risk for side effects, the patients truly aren’t being helped. With so many different ways to help women balance their hormones, it is important to look at each patient individually.

One of the simplest ways to determine which women are the best candidates for Hormone Replacement Therapy is to look at specific biomarkers. Biomarkers are characteristics within your body that can be measured and evaluated. A biomarker could be a physical measurement like your height or an internal measurement like a white blood cell count. In the case of prescribing Hormone Replacement Therapy, Dr. Manson suggests evaluating the following biomarkers:

-total cholesterol

-HDL cholesterol

-LDL cholesterol

-blood pressure

-blood sugar level (triglycerides)

-excess body fat around the waist

Women who have good/clear test results are considered low-risk and are the best candidates for Hormone Replacement Therapy– they have the lowest risk of developing side-effects. If a woman has high cholesterol, high blood sugar, and has excess fat around her waist, she would be considered higher risk, and it might not be appropriate to put her on hormone therapy. The more biomarkers a woman has, the higher her risk level for developing side effects.

It is our job as medical professionals to prescribe medication safely; we aim to reduce symptoms while at the same time preventing side effects. It’s very important that your doctor only prescribe Hormone Replacement Therapy to you if you are a good candidate.


Article Reference:

Which Women Are the Best Candidates for HRT?   Medscape. Apr 10, 2015.

Posted in Diagnosis, Hormone Therapy, Hormones, Medications and Prescriptions, Symptoms, Treatments

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