What is hormone replacement therapy (HRT)?
Hormone replacement therapy (HRT) for women is a treatment that supplements or replaces decreased hormone levels. Typically, HRT is given to manage menopausal symptoms such as vaginal dryness, hot flashes, decreased sex drive and mood swings. Doctors prescribe HRT for menopause to replenish estrogen levels, which can reduce symptoms and provide relief. Progesterone’s role in HRT is mainly to protect the lining of the uterus from growing too much.
What does hormone replacement therapy do?
Hormone replacement therapy replaces the ovarian hormones that naturally decline during menopause. A common treatment for menopause is usually a medication with estrogens, sometimes combined with progesterone, which are reproductive hormones that play a vital role in a woman’s overall health. As estrogen levels are replenished, it reduces or eliminates many common symptoms of menopause. Many women wonder, “Is HRT right for me?” It’s important to talk to your doctor to discuss your symptoms and medical history and create a treatment plan that’s right for you.
Is hormone replacement therapy (HRT) safe?
Before starting hormone replacement therapy for menopause, a common question is whether it is safe to use. The good news is that for the vast majority of women, HRT is very safe. While there are potential side effects like many prescription drugs, there are also many benefits, which we will discuss further below.
How do I know if I need hormone replacement therapy?
Hormones know the big role hormones play in keeping our bodies happy and healthy, so if you think they’re out of whack, it can be a little scary. If you are experiencing menopausal symptoms, you may be wondering, “Do I need hormone replacement therapy?” What are the signs that you need hormone replacement therapy? In general, a good way to know if you may need HRT is by monitoring your menopausal symptoms. If they interfere with your daily life, you may be a first candidate for this helpful treatment. Symptoms that can improve with hormone replacement therapy include:
Hot flashes
Hot flashes cause sudden heat in the neck, chest and face, along with a fast heartbeat, flushing and sweating.
Night sweats
Night sweats, which are hot flashes that happen at night, can disrupt sleep and leave you drenched in sweat.
Bone loss
Bone loss, or osteoporosis, weakens the bones and puts you at increased risk for fractures and breaks.
The mood changes
This includes unusual mood swings, irritability or feeling upset about things that wouldn’t normally bother you.
Dryness of the vagina
Hormonal imbalances can cause vaginal dryness, which can lead to painful sex and decreased libido.
Sleep problems
Sleep problems can include difficulty falling asleep or staying asleep, leading to fatigue.
Hair loss
A sign of low estrogen levels is thinning and hair loss.
When to start hormone replacement therapy?
Knowing when to start HRT can be difficult, as the onset of menopause symptoms is unique to each woman. In general, it is best to start hormone replacement therapy within ten years of menopause or before the age of 60. For younger women, you can start HRT in perimenopause if you start to experience symptoms. It’s important to remember that there are many factors that can affect your hormone levels, so it’s best to talk to your doctor about if and when you need hormone replacement therapy.
Benefits and risks of hormone replacement therapy
There are many benefits of hormone replacement therapy for the whole body. While many women see significant improvement with HRT before and after menopause, as it helps control mood swings, hot flashes, vaginal dryness and other symptomsthere are additional benefits you should be aware of. HRT is known to help with prevention of osteoporosis as it reduces and slows bone loss and can reduce the risk of heart disease and diabetes. It also boosts sex drive as it replenishes estrogen levels, a key reproductive hormone.
When it comes to the risks that female patients may face before and after HRT, their lifestyle and medical history can have a big impact. Some of the top risks to be aware of include:
- Stroke and heart disease – HRT puts you at higher risk for blood clots in the legs and lungs, stroke and heart attack.
- Cancer – Using hormone replacement therapy for prolonged periods can increase the chance of ovarian and breast cancer. In addition, you are more likely to develop breast cancer after stopping HRT because of your progesterone and estrogen levels.
- Vaginal bleeding – The introduction of estrogen and progesterone can cause vaginal bleeding.
- Dementia – In women over 65, HRT may increase the chance of dementia.
- Urinary incontinence – Some women may experience urinary incontinence while taking HRT.
- Headaches – Headaches and migraines can get worse with HRT.
Advice on choosing the right type of HRT and when to start it
When deciding whether HRT is right for you, there are a few factors to consider.
Your age
As we discussed earlier, most women start hormone replacement therapy before they turn 60 or within ten years of experiencing menopausal symptoms. If you start treatment more than ten years after menopause, it can increase the risk of health conditions.
The type of HRT
THE type of hormone replacement therapy you get depends on whether you still have your uterus and your menopause. The most common treatments include the following.
- Active Ingredients: Conjugated Equine Estrogen (CEE), Ethinylestradiol, Micronized 17β-Estradiol, Medroxyprogesterone Acetate (MPA), Norethindrone Acetate, etc.
Estrogen-only HRT – Estrogen-only HRT is required for women who have had a hysterectomy.
Estrogen and Progesterone – For women who have a uterus, progesterone is needed to prevent the lining from thickening.
- Route: HRT can be administered transdermally, vaginally, or orally. The dosage varies according to your individual needs, which will be determined by your doctor.
Daily – Estrogen-only HRT is usually given daily.
Continuous combined HRT – If you haven’t had a period for more than a year and are postmenopausal, continuous combined HRT, which contains estrogen and progestogen, is a good option.
Sequential HRT – Sequential HRT is for perimenopausal women who still have periods. It contains progestogen and estrogen and is only available in monthly or 3-month supplies. With this treatment, you stop taking progestogen for specific periods of time while you continue estrogen.
For women at risk of deep vein thrombosis, or DVT, transdermal estrogen, which comes in a gel, spray, or patch, is a safer option. Since it is absorbed into your blood vessels, it will not increase your risk of DVT like traditional estrogen tablets.
Doses
There are different doses of HRT depending on the type of treatment you choose, ranging from extremely low to high. Many women wonder: “How do I know if I need a higher dose of HRT?” Working with your doctor, you can determine if your current dose is reducing your menopausal symptoms and adjust it accordingly. Most women will start on a low dose and increase it if necessary.
How do you know if you need hormone replacement therapy (HRT)? The key is to know the signs and work with your doctor to develop an effective treatment plan. Menopause is no fun and can disrupt your daily life. Fortunately, hormone replacement therapy can help you manage your symptoms so you can feel better and get back to what really matters. The Hormona app is proud to provide women with an easy way to track their hormonal health. This award-winning app gives you the tools and knowledge to understand your body so you can feel better!
FAQ
What are the first signs that HRT is working?
You’ll know your HRT is working when you start to sleep better, have an improved mood and your libido returns. You may also experience dry skin and more bruising within the first two weeks.
Is it better to go through menopause without HRT?
There is no right or wrong when it comes to taking HRT during menopause. It all depends on the severity of your symptoms and whether treatment can improve your daily life.
Is it OK to stay on HRT for life?
While it’s possible to stay on HRT for life, whether or not it’s okay depends on your individual needs and overall health. The risks of taking HRT increase as you get older, so keep that in mind.
Are you aging more slowly on HRT?
Interestingly, yes, HRT can slow down aging. Studies show an impact on both biological and cellular agingalong with benefits such as delaying bone loss.
How do I know when to come off HRT?
Once menopausal symptoms are manageable, you can usually stop taking HRT. It usually takes 2 to 5 years for this to happen, and it’s important to talk to your doctor before stopping any treatment plan.
