Menopause is a natural part of a woman’s life chracterised by the decline of reproductive hormones, usually between 40 and 50 years of age. You are officially in menopause when you have not had a menstrual cycle for 12 consecutive months.
At this time, your ovaries stop releasing egg cells and your production of estrogen and progesterone decrease significantly. This is where hormone replacement therapy (HRT) comes in. It is commonly used to alleviate symptoms associated with menopause, though it can also be beneficial for other conditions.
GlobMed can help you assess whether HRT is right for you, and find the best professionals to guide you in the journey to improved overall health.
What Happens During Menopause?
As women age, hormone levels in the body, such as oestrogen and progesterone tend to decline. This hormonal decline can lead to a variety of physical and emotional symptoms that can greatly impact your daily life. You might experience hot flushes, night sweats, mood changes, decreased bone density, and changes in sexual function.
What Is Hormone Replacement Therapy?
Hormone replacement therapy involves the use of medications that contain hormones to supplement or replace the hormones that your body is no longer producing enough of. For treating menopause, the most common hormones used in HRT are oestrogen and progestogen (the drug version of progesterone).
What Are The Benefits Of Hormone Replacement Therapy?
Hormone replacement therapy can ease symptoms of declining hormone levels. Hormone replacement therapy can also help you prevent osteoporosis (bone-thinning disease), if you have an oestrogen deficiency (if you have lost normal ovarian function before 40), if you have had a hysterectomy before 45, or if you are experiencing early menopause (when periods cease before 45).
Some of the most common benefits of HRT can include:
Hot Flush Relief:
One of the most common symptoms of menopause is hot flushes, which are sudden sensations of heat that can cause sweating and discomfort. HRT has been shown to reduce the frequency and severity of hot flushes, helping women regain control over their body temperature.
Improved Mood And Sleep:
Hormonal imbalances can contribute to mood swings, irritability, and sleep disturbances. Hormone replacement therapy can help stabilise hormone levels, leading to improved mood and better sleep quality.
Maintaining Vaginal Health
Decreased oestrogen levels during menopause can cause vaginal dryness and discomfort. HRT can help restore vaginal health by increasing lubrication and reducing symptoms such as itching and pain during intercourse.
Prevention of Bone Loss
Oestrogen plays an important role in maintaining bone density. As women age and oestrogen levels decline, the risk of osteoporosis and fractures increases. Hormone replacement therapy can help reduce bone loss and lower the risk of osteoporosis-related complications.
Reduce Heart Disease Risk
Oestrogen has several beneficial effects on the cardiovascular system. When oestrogen levels decline during menopause, these protective effects are diminished, which can lead to an increased risk of developing heart disease, including conditions such as coronary artery disease, heart attacks, and strokes.
What Are The Different Types Of HRT?
There are several ways to take hormone replacement therapy. It can be administered in the form of patches, gels, sprays, tablets, or vaginal tablets/rings/creams (useful when experiencing bladder symptoms or vaginal dryness). You may even be given a combination of these forms depending on your needs.
Hormones can be taken on a continual basis, or in cycles. Your chosen healthcare practitioner will consider personal preferences, as well as where you are in the menopause process, when choosing the right form of HRT for you.
- Oestrogen-only: Oestrogen-only HRT can relieve symptoms of menopause and strengthen bones. This type of HRT is often recommended after a hysterectomy.
- Combined HRT: Combined HRT consists of both progestogen and oestrogen. The addition of progestogen can help to protect against the increased risk of uterine cancer that occurs when taking oestrogen.
- Testosterone: You may be given testosterone if you are experiencing low libido (sex drive) and HRT alone hasn’t worked. Speak to your doctor about whether this is an option.
What Are The Risks And Considerations Of HRT?
Hormone replacement therapy is associated with a small increase in the risk for:
- Blood clots
- Breast cancer
- Uterine cancer
- Ovarian cancer
- Stroke
If you have high blood pressure, it needs to be under control before starting HRT and the treatment may not be suitable for those with liver disease or during pregnancy.
Individual experiences with HRT vary. While many benefit, others may find it less effective or experience side effects like bloating, tender breasts, nausea, leg cramps, fluid retention, headaches, mood swings, acne, depression, stomach or back pain, and vaginal spotting.
Side effects generally improve over time, and not everyone experiences them. Regular monitoring and open communication with your doctor are vital to ensure HRT works well for you.
Frequently Asked Questions
Most women can, but you might not be prescribed HRT if you have, or have had, any of the following: endometrial cancer or breast cancer, blood clots, heart attack or stroke, liver disease, undiagnosed unusual vaginal bleeding, or untreated endometrial hyperplasia.
There is no evidence that HRT leads to weight gain. You are more likely to put on weight because of menopause itself. Regular exercise and a healthy diet can help to manage your weight during menopause.
Yes, depending on the time frame. HRT is not a contraceptive, so if you want to avoid pregnancy you will need to use contraception for two years after your last period (if you are under the age of 50) or one year after your last period (if you are over the age of 50).
There is no time limit, but your healthcare practitioner should provide a recommendation for the length of treatment. Risks caused by HRT will also be influenced by the duration of treatment.
Lifestyle measures, antidepressants, tibolone (which mimics combined HRT but with weaker effects), or clonidine are some of the alternatives to HRT, depending on the concerns that require treatment. Speak to your doctor about alternatives if HRT does not seem appropriate for you.
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