Hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT) or postmenopausal hormone therapy (PHT), is a treatment that doctors may recommend to relieve common symptoms of menopause. HRT can treat hot flashes, night sweats, vaginal dryness, sleep problems, and mood changes by replacing hormones that decline during perimenopause and menopause.
The main types of HRT are:
- Estrogen therapy - Estrogen tablets, patches, gels, or creams can relieve hot flashes, vaginal dryness, and urinary symptoms. Types include conjugated equine estrogens (CEE) or 17β-estradiol.
- Progestin therapy - Progestins like progesterone counteract estrogen's effects on the uterus to lower uterine cancer risk in women with a uterus. They come as pills, patches, shots, or intrauterine devices.
- Combination therapy - Combining progestin with estrogen is recommended for women with a uterus to prevent overgrowth of uterine tissue.
How HRT works
HRT restores hormone levels that drop during perimenopause and menopause. The natural decline of estrogen and progesterone leads to menopausal symptoms. Replacing these hormones can:
- Reduce hot flashes and night sweats
- Improve vaginal dryness and elasticity
- Prevent bone loss and fractures
- Improve sleep quality
- Boost mood and cognitive function
HRT administration
HRT hormones come in various forms like pills, skin patches, gels, sprays, rings, or creams. Your doctor will help determine the best delivery method based on your symptoms and needs. Some key points:
- Oral HRT enters the bloodstream through the digestive system, which can cause side effects like blood clots or gallbladder disease in some women.
- Transdermal HRT (via patch, gel, etc) avoids the digestive system and may have fewer risks.
- Localized vaginal estrogen creams, rings, or tablets treat genitourinary symptoms directly with less systemic absorption.
HRT candidates
Good HRT candidates include women:
- With moderate to severe menopause symptoms affecting quality of life
- Under age 60 or within 10 years of menopause onset
- Without risks like blood clots, heart disease, breast cancer, etc
The benefits and risks of HRT vary based on the individual, so personalized guidance from a doctor is essential. Most women take the lowest HRT dose that relieves their symptoms and stop treatment when menopausal symptoms subside.
HRT risks and side effects
While research shows HRT is generally safe for healthy women in their 50s, potential side effects can include:
- Breast tenderness
- Bloating, nausea, or cramping
- Mood changes or depression
- Gallstones
- Blood clots (higher with oral HRT)
The longer a woman uses combination HRT past age 60, the higher her breast cancer risk. But this risk returns to normal within 5 years of quitting HRT. Yearly mammograms help detect any potential breast changes early.
HRT alternatives
For women who cannot take HRT, some alternatives to relieve menopause symptoms include:
- Antidepressants like SSRIs for hot flashes
- Vaginal moisturizers and lubricants
- Lifestyle changes like stress management techniques
- Herbal remedies like black cohosh or phytoestrogens
However, herbal products are not regulated for safety or purity. Vitality Renewal Clinic provides customized bioidentical HRT for women seeking a natural hormone balance with minimal side effects under doctor supervision. Contact us today for a consultation.
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