Obstetrics & Gynecology

Answer 4 Improved visual acuity. Evidence suggests that estrogen therapy improves visual acuity, perhaps by causing a beneficial effect on lacrimal fluid. Postmenopausal women who use hormone replacement therapy (HRT) have been found to have a markedly reduced risk for macular degeneration, a cause of painless central visual loss in elderly patients. The increased prevalence of keratoconjunctivitis sicca in menopausal women is often symptomatically relieved by HRT. Reduced risks for colorectal cancer have been reported in former users of HRT; this effect is greater in current HRT users and increases with duration of use. Estrogen therapy prevents osteoporosis (ie, bone loss) by decreasing bone resorption, increasing calcium absorption, reducing renal clearance, and reducing osteoporosis-related fractures. Estrogen therapy is most effective when initiated within 5 years of menopause and continued into later years. Urogenital atrophy is caused by the hypoestrogenic state of menopause. Treatment with estrogen can restore vaginal blood flow, which allows for the growth of normal microbiologic flora of the vagina that is dependent on the glycogen content of the epithelial. Thus, normal vaginal pH, moisturization, and a protective ecologic milieu are restored by HRT therapy. Hot flashes, which occur in approximately 75% of menopausal women, are unrelated to HRT therapy. Click here to return to the questions

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