hormone replacement therapy woman

Hormone Replacement Therapy 101

Hormone replacement therapy, or HRT, are medications that include, well, hormones. Fluctuating hormones, like your estrogen dropping during menopause, is normal for everyone. But the fluctuations may leave you feeling lousy. For example, lower estrogen causes a lot of the symptoms of menopause, like hot flashes.

In addition to leveling out your hormone levels, hormone replacement therapy can prevent bone loss for post-menopausal women and provides other benefits, too. Though, it isn’t right for everyone and there are some risk you should consider before making a final decision.

Isn’t There Some Hormone Replacement Therapy Controversy?

Let’s be honest. There’s controversy in a lot of things. Some people think it’s not right to add hormones to the body. Others are scared about side effects. Synthetic HRT has indeed been known to cause an increased risk of breast cancer, strokes, blood clots and other scary things.

We’re not talking about the synthetic stuff, though. That’s made from horses, and we aren’t horses. Traditional hormone replacement therapy is much safer, but a lot of groups have called for more testing. More testing is always good, but traditional hormone replacement therapy is not the synthetic stuff and has been used for a long time with much success.

What Are Your Options?

There are actually four different ways hormone replacement therapy can be taken. You can take HRT in the following forms: pills, skin patches, topical ointments like gels or creams, or vaginal suppositories like rings or creams. At least there are no shots required!

All of these approaches give different types of hormones and act differently. For example, the skin patches often deliver a lower dose and you use them only once or twice a week. Meanwhile the vaginal rings and other inserts are for specific problems like vaginal dryness or pain during intercourse. What you use all depends on the issue you’re trying to solve, so talk to a doctor before deciding which is right for you.

Are There Any Benefits To Hormone Replacement Therapy?

The pills, patches and ointments are the most effective ways of getting hormones into the body and provide the most benefits. HRT delivered this way can get rid of menopausal symptoms like hot flashes and random sweating, while also helping with a variety of vaginal issues such as vaginal dryness and discomfort during intercourse.  

As an extra bonus, a combo of estrogen and progesterone therapy can reduce the risk of colon cancer, and other forms of estrogen can decrease the risk of heart disease. Of course, hormone replacement therapy also protects against bone thinning, like we mentioned. All in all, you’re getting a pretty good deal.  

Back to those vaginal inserts, though, like tablets and rings. If you go that route, you’ll find that these are typically lower-dose medications. And, they typically treat vaginal symptoms only. But, they may also help with urinary problems, too, such as bladder leaks (aka incontinence). These types of meds, though, don’t help with hot flashes or bone-thinning.

What About The Risks Of Hormone Replacement Therapy?

We talked about side effects from synthetic HRT. Let’s talk about the risks from traditional hormone replacement therapy. In one large clinical trial, the estrogen-progestin pill Prempro caused an increased risk of some serious conditions. Those conditions were heart disease, stroke, breast cancer and blood clots.  

Studies for other medications found that the risks vary by age. Women who start HRT about 20 years after the start of menopause or who are age 60 or older when they start HRT have an increased risk of those serious conditions we mentioned. The thing is, most doctors find that the benefits greatly outweigh the risks. Again, this is a thing you should talk to your doctor about to find out what’s right for you. All medical treatments are about weighing the benefits and risks for you personally.  

A lot of these risks come from that combination of estrogen and progestin that we talked about. Sometimes it depends on the dose and type of medication. If you already have some health factors like a high risk of cancer, hormone replacement therapy can increase this risk further. This is why you should talk to the doctor. With everyone being so different, what does or doesn’t work for someone else might be just fine for you.

Time To Try HRT?

Most hormone replacement therapy medications are great for managing menopausal symptoms, which some of us already know can be really terrible. Coupled with a few healthy lifestyle changes like less alcohol or breathing exercises, hormone replacement therapy can help to take the edge off of menopause. As far as the vaginal inserts are concerned, combating pain during intercourse or burning sensations has never been better.  

Hormone replacement therapy isn’t always a cure-all, though. It’ll work better for some people than others. You and your doctor can make the decision that is right for you, based on your symptoms, health risks, and medical history. What has your experience been with hormone replacement therapy? 

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By Jessica Thomas, MPH