Hormone Replacement Therapy (also see information for Menopause)
What is Hormone Replacement Therapy ( or HRT ) ?
At menopause, a woman's body makes less estrogen and she stops having menstrual periods. This is a natural stage in a woman's life. The lack of estrogen can bring on symptoms such as hot flushes and vaginal dryness. It also can increase the risk of osteoporosis (bone loss). Because of this, women may choose to take hormone therapy (HT) to restore estrogen after menopause.
Benefits of Hormone Therapy
Hormone therapy can relieve the symptoms of low estrogen levels (hot flushes and vaginal dryness) and decrease the risk of osteoporosis. The decision to begin HT depends on your:
- Personal needs
- Medical and family history
- Risk of bone loss
About 75 percent of all women going through menopause have hot flushes (hot flashes). A hot flush is a sudden feeling of heat that spreads over the face and body. The skin may redden like a blush. Hot flushes may come on a few times a month or several times a day, depending on the woman.
Protection from Osteoporosis
Osteoporosis in women results from low estrogen levels. Estrogen helps protect against bone loss. After menopause, a woman's bones slowly lose strength and become more fragile. As a result, older women are more likely to break bones. The hip, wrist, and spine are affected most often.
Hormone therapy can help slow bone loss after menopause.
Exercise also can help prevent bone loss.
Loss of estrogen causes changes in the vagina. Its lining may become thin and dry. These changes can cause pain during sexual intercourse. They also can make the vagina more prone to infection, which can cause burning and itching.
Some studies have shown that estrogen has a positive effect on mood and short-term memory in women.
Concerns and Risks
Like most treatments, hormone therapy is not free of risk. Using estrogen alone causes the lining of the uterus to grow and increases the risk of endometrial cancer. To reduce this risk, your doctor will recommend another hormone called progestin if you have a uterus.
All women are at risk of breast cancer. This risk increases with age. An issue of great concern to women is whether hormone therapy in-creases the risk of breast cancer. Women who take combined (estrogen and progestin) HT have an increased risk. The risk appears to be small, but increases throughout the time that HT is taken. Women who take HT also are at increased risk of stroke, heart attack, and forming blood clots.
When they choose to take HT, most women who have a uterus take estrogen and a progestin.
Hormone therapy can be given in many ways.
- Continuous cyclic therapy
- Continuous-combined therapy
- Cyclic therapy
When taking hormone therapy or other medications, you should follow your doctor's advice carefully and get regular checkups.
Hormone therapy can help relieve some of the symptoms that affect women at menopause. Before making a decision about HT, talk to your doctor about what may work best for you, considering your personal needs and family and medical history.