Is extended hormone therapy safe during menopause?

LOS ANGELES (KABC) -- Women battling common menopausal symptoms such as hot flashes and insomnia will often refuse hormone replacement therapy, or limit its use. But one local expert says for some women, staying on hormone therapy indefinitely can be a safe option.

Dr. Steven Rabin, a board-certified gynecologist points out that symptoms like fatigue and dryness are not small problems.

"People who don't get adequate sleep aren't just tired the next day, they're at much higher risk of obesity, heart disease and many other serious diseases," said Rabin.

Rabin says many hormone concerns are based in fear and myth. More than a decade ago, the Women's Health Initiative study revealed a slightly higher increase in breast cancer risk from hormone use. After that, the guidelines changed.

"What the recommendation is you want to use the lowest effective dose for the shortest time necessary, based on a patient's individual risk factors, symptoms and desires," said Rabin. "So you'll hear guidelines that say 'stop them after five years,' 'stop them after 10 years,' and a lot of these are very, very arbitrary and are not really in the spirit of original recommendations."

Rabin says women who continue to have symptoms when they're not on hormones can be re-assessed yearly and can possibly stay on the treatment indefinitely.

"Nothing is without risks, but there are risks of not using hormones: osteoporosis, heart disease, Alzheimer's," said Rabin.

Dr. Rabin points out there's a lot of confusion when it comes the term "bioidentical." It means hormones chemically and biologically identical to what the human body makes. It doesn't always mean "plant-based" or "natural."