What is Hormone Replacement Therapy (HRT) for Women?
Hormone replacement therapy (HRT), also called “menopausal hormone therapy (MHT)”, is a remedial treatment used to relieve uncomfortable symptoms caused by menopause.
After menopause, levels of the reproductive hormones estrogen and progesterone gradually decrease over time. These hormones regulate your reproductive cycle and help the body utilize calcium.
HRT is a program in which estrogen is administered with or without progestin (a synthetic form of progesterone) to normalize the body’s hormone level, thereby easing any discomfort and symptoms of menopause.
Indications
The symptoms of menopause can begin many months before the actual onset of menopause and is called perimenopause. Symptoms can include:
- Hot flushes or flashes
- Night sweats
- Poor mood or mood swings
- Low energy or depression
- Vaginal dryness
- Low sex drive (libido)
- Discomfort during sex
- Urinary and sleeping problems
- Problems with concentration or memory
Benefits
HRT can replenish estrogen and progesterone levels in your body and relieve most menopausal discomfort. Additionally, it can:
- Prevent osteoporosis (weakening of bones)
- Reduce tooth loss and cataracts
- Reduce the risk of diabetes
- Improve your quality of life
How is Hormone Replacement Therapy Administered?
HRT can be administered in different ways, either continuously or in cycles. It is usually started as a low dose and increased later as needed. Your doctor will decide dosing and treatment regimens based on your health and particular symptoms.
Possible options for HRT are:
- Systemic Hormone Therapy: This is administered in the form of pills, skin patches, gels, creams or sprays. It remains the most effective type of treatment.
- Oral estrogen: Pills are taken once a day without food.
- Patch estrogen: The patch is worn on the lower abdomen.
- Topical estrogen: Creams, gels or sprays are applied to skin such as the arms or shoulders once a day. The estrogen is absorbed into the bloodstream through the skin.
- Low-Dose Vaginal Therapy: This is applied in the form of creams, tablets or rings.
- Vaginal estrogen: The creams, tablets or rings are applied directly into the vaginal area.
- Bioidentical HRT: Hormones extracted from natural elements that are blended and used either orally, topically or vaginally.
- Hormone Pellet Therapy: This is a form of hormone therapy that utilizes hormones extracted from plants and formed as pellets which can be implanted under the skin to optimize hormone levels. The pellets release a constant flow of hormones at a gradual rate avoiding rapid increase and decrease of hormone levels which produces extreme mood swings and energy fluctuations. The pellets are about the size of a grain of rice and can be inserted during an in-office procedure under the skin through a very tiny incision under local anesthesia.
In addition, a combination of estrogen/progesterone (progestin) hormone therapy may be administered depending on the requirement. Hormone replacement therapy tailored to the specific woman is found to deliver the best results.
Risks Associated with Hormone Replacement Therapy
Though potential risks of HRT may vary depending on medical history and lifestyle, some of the common risks can be:
- Blood clots or stroke
- Heart disease
- Breast cancer
- Uterine cancer
- Ovarian cancer
- Uterine cancer
- Gallbladder disease
Hormone replacement therapy may also lead to side-effects such as:
- Breast tenderness or swelling
- Vaginal bleeding
- Headaches, nausea
- Abdominal pain
- Leg cramps