If you are a woman dealing with menopausal symptoms, such as hot flashes, night sweats, mood swings, insomnia, low libido, or painful intercourse, you may be wondering whether hormone replacement therapy (HRT) can help relieve these symptoms without causing other medical complications.
When a woman begins her perimenopause transition period, her estrogen and progesterone levels start to drop. Consequently, she produces a fraction of the hormones she had before menopause, which is what often triggers the aforementioned symptoms. Some women suffer from hormone imbalances due to genetics or a physical illness.
Hormone replacement therapy involves synthetic hormones that you take to replace the natural ones your body stops making during menopause or during a hormone imbalance, thus helping to alleviate your symptoms. HRT has also been proven to help prevent bone loss and reduce fractures in postmenopausal women.
There are, however, risks associated with HRT, depending on the type of hormone therapy used, the dosage, how long you take the medication, and your individual health risks. That’s why, for the best results, HRT should be tailored for each person and reevaluated periodically to make sure the benefits outweigh the risks.
To determine whether HRT is right for you, it helps to understand what kinds are available, and their possible positive and negative effects.
The Basic Types of HRT
Hormone replacement therapy mainly focuses on replacing the estrogen that your body no longer produces. As such, there are two main types of estrogen therapy:
- Systemic estrogen comes in pill, skin patch, ring, gel, cream, or spray form and typically contains a higher dose of estrogen that is absorbed throughout the body. It can be prescribed to treat any of the common symptoms of menopause.
- Low-dose vaginal estrogen comes in cream, tablet, or ring form and is designed to minimize the amount of estrogen absorbed by your body. As such, these low-dose vaginal preparations are usually reserved for the treatment of vaginal and urinary symptoms of menopause.
Doctors will typically prescribe estrogen along with progesterone or progestin for women who have not had their uterus removed. The reason is that estrogen alone can stimulate the growth of the lining of the uterus, which could increase the risk of endometrial cancer. If you have undergone a hysterectomy, you may not need to take progestin.
The Risks of HRT
In a number of recent clinical trials, hormone replacement therapy consisting of an estrogen-progestin pill was found to increase the risk of certain serious conditions, including blood clots, breast cancer, heart disease, and stroke.
However, studies have also suggested that these risks vary depending on factors such as your age, the type of HRT used, and your family and personal medical history as it pertains to cancer, heart disease, stroke, blood clots, liver disease, and osteoporosis.
You and your doctor should consider these risks when deciding whether HRT is an appropriate option for you.
The Benefits of HRT
If you are healthy, systemic estrogen therapy is the most effective treatment if you have moderate to severe hot flashes and night sweats, and other symptoms of menopause, such as dryness, itching, burning, and painful intercourse. It can also help protect you against osteoporosis (bone-thinning disease).
If you have had your ovaries surgically removed before age 45, experienced premature or early menopause before 45, or lost normal function of your ovaries before age 40, estrogen therapy can help reduce your risk of certain health conditions, such heart disease, stroke, osteoporosis, dementia, and mood swings.
