Hormone Replacement Therapy Treatment in Women: What to Know

Hormone Replacement Therapy Treatment in Women: What to Know

Everything you need to know about women's health

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

Hormone Replacement Therapy (HRT) is a treatment designed to numb the symptoms of menopause. It involves replacing hormones that your body no longer makes or are at lower levels as you approach menopause. What does this treatment mean for you? Are there health risks? Explore the guideline below to find out and decide whether HRT is right for you.  

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

  •  Reduction in vasomotor symptoms. The frequency and severity of symptoms such as hot flushes lowers significantly within four weeks. Maximum benefit is gained after three months of treatment
  • Improved quality of life. Mood improves and depressive symptoms go down
  • Improved urogenital symptoms. This includes significant improvement in sexual function and vaginal dryness. HRT also causes relief in urinary frequency
  • Reduced osteoporosis risk. This is because estrogen effectively increases bone mineral density.
  • Reduced risk of cardiovascular disease. However, this can vary depending on your preexisting conditions
  • Lowered risk of colorectal cancer
  • Lowered risk of getting type II diabetes

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 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.

Who Can Take HRT?

There is a huge need for an individualized approach to menopause diagnosis, investigation, and management. However, investigations might not be necessary unless under any of the following conditions:

  • Swift change in menstrual pattern, intermenstrual, postcoital, or postmenopausal bleeding
  • Personal or family history of vaginal thromboembolism
  • High risk of breast cancer, womb cancer, ovarian cancer
  • Have a history of blood clots
  • Have liver problems
  • Arterial disease or high-risk of the same 
  • Are pregnant

Alternative menopausal treatments may be advisable under the above conditions.

Types of Hormone Replacement Therapies

It is important for you to get the right HRT type as they vary widely. Variations occur in:

  • HRT hormones – They feature a combination of estrogen and progesterone and most women take them. However, if you already have had your womb removed, you can take estrogen-only
  • Methods of taking HRT – They vary from skin patches, tablets, vaginal creams, gels, rings or pessaries
  • HRT treatment cycles – You can take HRT continuously without any breaks or use in cycles where you take estrogen continuously and progesterone with breaks

A GP can help you to decide on the HRT that works best for you. If the first HRT fails, then you can switch until you find the appropriate one.

When to stop Hormone Replacement Therapy

There are zero limits to the time period you can take HRT for. However, a GP can recommend an appropriate period depending on your condition. Most women prefer to stop the medication after a few years when the menopausal symptoms die out.

Breast cancer risk is higher in women who take HRT than those who do not. This risk is associated with all forms of HRT except vaginal estrogen. When you stop taking HRT the continued risk ends. However, it is still prevalent for 10 years as compared to those who do not take HRT.

You can choose to stop HRT gradually or abruptly. Stopping gradually allows your body to adjust and prevents the symptoms from reappearing. Contact a GP if you get continued symptoms after stopping or if the symptoms are too severe. You might have to continue taking HRT.

What Are the Side Effects of HRT

HRT can cause the following side effects which pass after three months of taking the medicine:

  • Headaches
  • Breast tenderness
  • Indigestion
  • Feeling sick
  • Vaginal bleeding
  • Abdominal (tummy) pain

Alternatives to Hormone Replacement Therapy

  • 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

You might experience different types of complications as they transition to menopause. The biological, vulvovaginal, psychological, sexual, urinary and cognitive issues can cause a significant challenge. They may affect your relationships with family members, friends, or even co-workers.

The symptoms of menopause brought about by hormonal change can, however, be culled out through HRT. Our providers at Nore Women’s Health can help you identify the HRT 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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