Hormone replacement therapy (HRT) can help balance estrogen and progesterone levels during or near menopause.
There are also many other reasons why a doctor might prescribe supplementary sex hormones.
Also known as menopausal hormone therapy, HRT can help relieve sweating, hot flashes, and other symptoms of menopause. It can also reduce the risk of osteoporosis.
Some types of HRT contain both progesterone and estrogen, while others contain only estrogen. Sometimes they contain testosterone.
Below, learn about the uses, types, and risks of HRT.
Uses
A person may use HRT to manage symptoms of menopause. Hormone treatment can help address a range of issues.
The right combination and dosage of the hormones will depend on the reason for prescribing this form of treatment.
Menopause
Menopause is not an illness. It is a natural transition from the years in which a female can reproduce to the next phase of life.
Many people go through menopause without requiring any treatment. However, if the transition causes troubling or distracting symptoms, a variety of treatment approaches are available.
Around menopause, many women experience:
- hot flashes and night sweats;
- vaginal dryness;
- bone thinning, or osteoporosis;
- urinary problems;
- thinning hair;
- sleep problems;
- mood changes;
- irregular periods;
- difficulties with concentration and memory.
HRT can help manage some of the above symptoms.
In addition, some studies have suggested that HRT may help:
- improve muscle function;
- reduce the risk of heart failure and heart attacks;
- reduce mortality among younger postmenopausal women;
- prevent skin aging, in some women, when used cautiously.
Other uses
A doctor may also prescribe different types and combinations of sex hormones for:
- birth control;
- low blood testosterone levels;
- a transition from the sex assigned at birth.
Hormones and menopause
Levels of progesterone and estrogen fluctuate throughout each month, in females, contributing to the menstrual cycle. These levels also change throughout a person’s lifetime.
Perimenopause
Levels of estrogen and progesterone start to fall when most females are in their 40s, but menstruation will continue for some time.
Periods may become less regular, and hot flashes and other menopause symptoms may start to appear during this time.
While menstruation continues, it is possible to become pregnant, although the chances reduce with time.
Perimenopause, or the lead-up to menopause, usually lasts for around 7 years, but it can occur for up to 14 years, according to the National Institute on Aging.
Menopause
Menopause begins 12 months after a woman’s last period. On average, this occurs at the age of 52 in the United States. After menopause, it is no longer possible to become pregnant without medical assistance.
Everyone experiences menopause differently, but hot flashes, mood changes, and other symptoms are common.
A study published in 2015 suggests that in more than half of females, vasomotor symptoms, such as hot flashes:
- last for more than 7 years;
- start before the final monthly period;
- continue for an average of 4.5 years after menstruation ends.
During this time, HRT can help manage the symptoms.
Early menopause
Menopause begins earlier for some people, and HRT can be helpful if this happens.
People who experience the transition early may:
- have had surgery to remove the uterus, ovaries, or both;
- have some types of cancer;
- have certain genetic or chromosomal factors;
- have certain autoimmune diseases;
- smoke.
Sometimes, the transition starts early for no clear reason.
Anyone who is scheduled to undergo surgery or another treatment that will affect their reproductive system should ask about the likelihood of experiencing early menopause.
A doctor can describe the range of treatments available, should a woman need them.
Side effects
While HRT can help manage hot flashes and other menopause symptoms, it can also have adverse effects.
Depending on the type of treatment, these may include:
- acne;
- bloating;
- indigestion;
- breast tenderness;
- swelling in the breasts or other parts of the body;
- abdominal or back pain;
- leg cramps;
- headaches;
- migraine;
- nausea;
- vaginal bleeding;
- mood changes;
- depression.
These side effects usually disappear after a few weeks.
It is important to let the doctor know about any side effects that cause concern. They may be able to adjust the dosage or suggest an alternative.
Is it safe?
In the past, it was common to use hormone therapy during menopause, but HRT may not be safe or suitable for everyone — especially for people with specific risk factors.
Now, most doctors agree that it is safe to take hormone therapy:
- for moderate-to-severe hot flashes and vaginal dryness;
- up to the age of 59 years;
- within 10 years of menopause;
- at the lowest possible dosage, for the shortest possible length of time.
However, the individual’s overall health and preferences should influence the decision.
Risks: Who should not use HRT?
HRT may not be suitable for women with a history of:
- uncontrolled hypertension, or high blood pressure;
- thrombosis or blood clots;
- high levels of triglycerides in the blood;
- stroke;
- heart disease;
- breast cancer;
- gallbladder disease.
Also, people should not use it if they are or may become pregnant.
Types of HRT
There are various ways of delivering hormone therapy, and the different types provide different combinations and amounts of hormones.
Common types include:
Estrogen-only HRT: A doctor may recommend this if a person has had their uterus and ovaries removed, in which case progesterone is not necessary.
Cyclical, or sequential, HRT: This may be a good option if symptoms occur before menopause; the dosage can align with the menstrual cycle.
Continuous HRT: After menopause, a doctor may prescribe a continuous combination of estrogen and progesterone.
Local estrogen: Vaginal tablets, creams, or rings can help with urogenital symptoms, including vaginal dryness and irritation.
How to take it?
The doctor will prescribe the lowest possible dosage that addresses the person’s symptoms, and arriving at this dosage may take some trial and error.
Ways of delivering HRT include:
- tablets;
- creams or gels;
- vaginal rings;
- skin patches.
When a woman no longer needs the treatment, the doctor will describe how to stop it gradually. If you’ve got some immediate questions right away, feel free to contact our expert for a free consultation.