What Is Hormone Replacement Therapy?
Hormone replacement therapy (HRT) is a medical treatment that is used by menopausal women to relieve menopausal symptoms caused by lower estrogen and progesterone in the body. It includes all medications that are used to replace the female hormones the body is not producing anymore in the female body. Hence, HRT artificially boosts* hormonal levels in a woman’s body in order to curb the effect of lower levels. Until recently, HRT was considered the standard treatment for menopausal women, but more and more women are now turning to natural methods to control their symptoms. There are a number of HRT options available if a menopausal woman is considering HRT treatment for her symptoms.
What Are the Types of Hormone Replacement Therapy for Women?
- Estrogen-only HRT
Estrogen-only HRT is suitable for women who have had a uterus removed. They do not need a progesterone boost* in their bodies. Progesterone is the hormone that prepares the uterus for pregnancy. It also protects the uterus lining (endometrium) from damage. If the body has lower progesterone levels, a woman may be at a higher risk of developing endometrial cancer. Unlike estrogen, lower levels of progesterone do not have any discernible symptoms. Hence, if she has had a hysterectomy, she does not need to top up her progesterone levels because there is no risk of cancer.
- Cyclical (sequential) HRT
Cyclical or sequential HRT is recommended for women who have menopausal symptoms while they are still menstruating. If a woman’s menstrual period is still regular, then the monthly HRT is recommended. This involves taking estrogen daily. Progesterone will then be taken for a period of 14 days once the menstrual cycle ends. If a woman has irregular periods (menstruation should be occurring at least every three months), then the 3-monthly HRT is recommended. This treatment involves taking a daily dose of estrogen. Then every 13 weeks a woman should take a 14-day progesterone dosage.
- Continuous HRT
Continuous HRT is recommended for women who are in the post menopause stage of their lives, meaning they have not had a menstrual period for at least 12 months. This HRT treatment entails a daily dosage of both estrogen and progesterone.
Who should consider Hormone Therapy?
All women who are experiencing menopausal symptoms can start taking HRT. This includes perimenopausal, menopausal and post-menopausal women. Women with certain health risks that are listed in the section below should avoid HRT as they may increase* their body’s susceptibility to certain diseases. It should also be noted that HRT is not recommended for use for more than five years. Most women use HRT for between two and five years only because of the health risks associated with HRT treatment.
Who should Avoid Hormone Therapy?
Women suffering from a number of health conditions should avoid HRT altogether. These health conditions include pregnancy, severe liver disease, breast cancer, endometrial cancer (uterus), ovarian cancer, untreated high blood pressure, stroke, heart disease, blood clots, migraine headaches, uterine fibroids and active gallbladder disease.
Hormone Replacement Therapy is Safe or Not?
According to several doctor’s groups who released a consensus statement, although HRT comes with risks, it is one of the most effective treatments for menopausal symptoms. HRT does come with risks, doctors acknowledge, but in most cases the benefits outweigh the risks especially for women who are below 60 and those who have been experiencing menopausal symptoms for less than 10 years. Hence, HRT treatment should be recommended on a case-by-case basis as some women could greatly benefit from its use without the risks.
What Are the Risks of Taking HRT?
Women who are experiencing severe menopausal symptoms, and start taking HRT, may be placing themselves at risk. These health risks include breast cancer, blood clots, stroke and heart disease. However, according to research studies, these risks are decreased* within five years of the end of the HRT treatment.
What are the Risks of Hormone Therapy?
- Heart Disease
Although it was assumed for many years that HRT actually helped to reduce* the risk of heart disease, recent studies have found the opposite – that HRT can slightly increase* the risk of certain heart diseases. In each of the research studies, it was shown that the dose and type of HRT as well as the commencement and duration, were important in determining the level of risk.
Women taking HRT have a small risk of having a stroke, according to research studies. The risk is small and depends on the woman’s health history, as well as the timing of the HRT.
- Blood Clots
HRT may also place women at risk of blood clots. This is particularly true for women who are already at risk of this condition before taking the HRT treatment, more especially those who have a history of the condition. The risk is also considered to be small for most women and more likely to occur only within the first year of taking HRT.
- Breast Cancer
Women who take HRT treatment for longer than five years are at risk of breast cancer. The different types of HRT treatment have different risk levels because combined HRT has an increased risk of breast cancer than estrogen-only HRT.
Natural Hormone Replacement
There are a variety of natural hormone replacement alternatives available for a woman who does not want to use HRT to alleviate menopausal symptoms. The first of these is bio-identical hormones. These are derived from plant and animal estrogen and progesterone, and are also used to top up a woman’s hormones. They unfortunately have the same effect as the regular HRT because they use the same basic principle of replacing hormones that are not being produced anymore. Women also have the option to use various herbal options. Most of these treatment options work differently from regular HRT treatment by stimulating the body to produce the hormones that it needs. These have to be combined with a lifestyle change that includes regular exercise, a balanced healthy diet and good sleep patterns.
Hormone Therapy is not all Good or all Bad
HRT is one of the best ways to combat menopausal symptoms. This treatment has unfortunately taken a lot of flak in the last few years because of the increased risk for some types of diseases. However, because of its positive effects, some women can benefit from it. Hence, doctors should assess each woman’s case separately, and recommend the best route based on medical history.