Hormone Replacement Therapy for Women: What to Know

Are You Considering Hormone Replacement Therapy Treatment? Here’s All You Need to Know

As women transition into menopause, fluctuating hormone levels can bring a range of uncomfortable symptoms, from hot flashes and night sweats to mood swings and vaginal dryness. For those seeking relief, Hormone Replacement Therapy (HRT) and Bioidentical Hormone Replacement Therapy (BHRT) are two widely used options. These therapies work by replenishing estrogen, progesterone, or a combination of both to restore balance and improve quality of life.

But what’s the difference between HRT and BHRT? While traditional HRT uses synthetic hormones, BHRT provides a more natural alternative, using plant-derived hormones that are chemically identical to those produced by the body. Both options can be effective in managing menopause symptoms, but the choice depends on individual needs, preferences, and medical history.

Understanding how these treatments work, their benefits, and potential risks is essential before deciding which approach is right for you. We explore HRT and BHRT in-depth, helping you make an informed choice about your menopausal health and well-being.

Progesterone and estrogen are some of the most important hormones to your reproductive system as a woman. While estrogen stimulates the release of eggs, progesterone prepares your womb for implantation. As you age, the supply of eggs diminishes, and so does estrogen production. These hormonal changes can cause hot flashes, vaginal dryness, mood swings, and other menopause-related symptoms.

Menopause symptoms can last 2 to 5 years and may resolve on their own. However, hormone replacement therapy, HRT or BHRT, helps relieve these symptoms, especially when they become severe enough to disrupt daily life.

Progesterone and estrogen are some of the most important hormones to your reproductive system as a woman. While estrogen stimulates the release of eggs, progesterone prepares your womb for implantation. As you age, the supply eggs diminish and so does that of estrogen. The changes in hormone levels can cause hot flashes, vaginal dryness, and other issues.

The menopause symptoms can last for 2 to 5 years and die out on their own. However, HRT helps to relieve such symptoms, especially when they are severe enough to disrupt your daily life. The treatment replaces the declining natural hormones with artificial hormones and is commonly called menopausal hormone treatment.

Benefits of HRT

Risks of HRT

HRT has undergone rapid change within the last 20 years. Once common in the 1980s and 1990s, the practice halted in the 2000s due to research on the risks associated with it. Recent studies have, however, allowed doctors to define the women who stand the highest benefit: risk ratio. Some of the known risks include:

• Stroke – Both estrogen and progesterone raise the chances of getting a stroke. However, the risk goes away as soon as you stop the medication
• Blood clots – The risk is higher if you take the medications orally. It is lower for if you use transdermal means such as injections and sprays
• Uterine cancer – This depends with whether you have a uterus and you should consult your doctor
• Breast cancer – You can take estrogen for 5 to 7 years, however, before the breast cancer risk rises. For progesterone, the risk raises after 3 to 5 years of taking the medicine.

How to Get Started with (HRT) Hormone Replacement Therapy

You can speak to a General Practitioner (GP) once you are ready to begin HRT. This can be as soon as you begin experiencing menopausal symptoms and no tests will be necessary. The GP will help you understand the different types of HRT and prescribe a low dose for you to begin with. Later on, they can increase the dose especially if has zero effects or change the HRT type.

What Is Bioidentical Hormone Replacement Therapy (BHRT)?

For women seeking a more natural alternative, Bioidentical Hormone Replacement Therapy (BHRT) provides another approach to hormone balancing. Unlike synthetic hormones used in conventional HRT, BHRT uses plant-derived hormones that are chemically identical to those naturally produced by the body.

How Does BHRT Work?

BHRT is often customized based on lab testing to match a woman’s specific hormone levels. It is available in different forms, including:

• Creams & Gels – Applied to the skin for slow absorption.
• Pills & Capsules – Oral supplements for systemic benefits.
• Pellets – Inserted under the skin, providing continuous hormone release over time.
• Patches & Troches – Convenient transdermal delivery options.

Benefits of BHRT for Women

Women choosing BHRT may experience:

• Relief from menopause symptoms – Reduces hot flashes, night sweats, and mood swings.
• Improved energy and mental clarity – Reduces brain fog and fatigue.
• Enhanced libido and sexual health – Helps restore hormonal balance for better intimacy.
• Better bone and heart health – May help prevent osteoporosis and cardiovascular disease.
• A natural and customizable approach – BHRT is tailored to match your body’s needs.

BHRT vs. HRT: What’s the Difference?

	HRT	BHRT
Source	Synthetic hormones	Plant-derived, bioidentical hormones
Personalization	Standardized doses	Custom-compounded for individual needs
Administration	Pills, patches, creams	Pills, creams, gels, pellets, and more
Common Users	Women experiencing menopause symptoms	Women seeking a more natural hormone balance approach

Who Can Take HRT or BHRT?

There is a huge need for individualized menopause treatment, and not everyone is a candidate for HRT or BHRT. Your doctor may recommend alternatives if you have:

• Irregular menstrual cycles or abnormal bleeding
• A personal or family history of blood clots
• A high risk of breast, ovarian, or uterine cancer
• Liver problems or arterial disease
• Are pregnant or trying to conceive

Alternative menopausal treatments may be advisable under the above conditions.

Types of Hormone Replacement Therapies

Choosing the right therapy is essential. HRT and BHRT vary in the following ways:

• Hormone Type – HRT commonly combines estrogen and progesterone, however, if you already have had your womb removed, you can take estrogen-only. BHRT uses bioidentical hormones.
• Method of Administration – Methods of taking HRT vary from skin patches, tablets, vaginal creams, gels, rings or pessarie. Bioidentical Hormone Replacement Therapy (BHRT) can be administered through creams and gels applied to the skin for steady absorption, oral pills and capsules processed by the digestive system, slow-release pellets implanted under the skin for long-term hormone delivery, transdermal patches worn on the skin and replaced weekly or biweekly, sublingual troches and tablets dissolved under the tongue for direct bloodstream absorption, and vaginal suppositories, creams, or rings designed for localized hormone therapy to relieve vaginal dryness and urinary symptoms.
• Treatment Cycle – Some regimens continuously supply hormones, while others follow a cyclical approach.

A doctor or specialist can help determine the best therapy for your needs. If the first option isn’t effective, alternative forms can be explored.

When to Stop Hormone Replacement Therapy

There is no strict time limit on how long you can take HRT or BHRT. Many women stop once menopause symptoms subside. However, your doctor may recommend a specific timeline based on your health status and personal risk factors.

Studies show breast cancer risk is higher in women who take HRT long-term. However, this risk drops when HRT is stopped, though it remains slightly elevated for up to 10 years compared to those who never used HRT.

You may choose to stop HRT gradually or abruptly, but a gradual approach may prevent symptom recurrence. Consult your doctor if symptoms return or become severe after stopping treatment.

What Are the Side Effects of HRT and BHRT?

Both HRT and BHRT may cause temporary side effects, including:

• Headaches
• Breast tenderness
• Indigestion and nausea
• Feeling sick
• Vaginal bleeding
• Abdominal pain

These side effects typically subside within three months of treatment.

Alternatives to Hormone Replacement Therapy

If HRT or BHRT isn’t the right fit, other options include:

• Lifestyle adjustments. Like regular exercise, eating healthily, lowering consumption of coffee, spicy foods, alcohol, and cigarettes
• Tibolone. It is similar to combined HRT but not as effective. It works only for women who had their period more than a year ago
• Antidepressants. Helps with night sweats and hot flushes, although they might cause side effects like dizziness
• Clonidine. Nonhormonal medicine that lowers night sweats and hot flushes although at low intervals

Bottom Line

Whether you choose HRT, BHRT, or alternative treatments, finding the right menopause management plan is essential.

Our providers at Nore Women’s Health can help you identify the hormone replacement therapy treatment that can help you get the much-needed relief. We take the time to listen and develop a customized treatment plan depending on your age and health needs. Request an appointment today to see one of our specialists or for further inquiries. 

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