The ABCs of Hormonal Replacement Therapy

• 21 Jan 2020

Hormone replacement therapy is usedto balance progesterone and estrogen in women during menopause. Also called menopausal hormone therapy (MHT) or hormone therapy (HT), this can help to ease hot flashes,sweating and other symptoms of menopause. It can also reduce the risk for osteoporosis.Some kinds of HRT consist of estrogen and progesterone, some only estrogen, and sometimes testosterone can be used.

Hormone replacement treatments are commonly used in male hormonal therapy for individuals who need to perform a sex change. Go through this blogpost to find out more about HRT as an effective way to relieve symptoms in women at the time of menopause.

Some facts on hormone replacement therapy or HRT

• Hormone replacement therapy is an effective way to relieve symptoms of perimenopause as well as menopause.
• It can decrease the incidence and severity of hot flashes and also the risk of osteoporosis.
• As per the studies, there is a link with cancer but this is still being investigated.
• It can help to keep your skin young, but it cannot delay or reversethe overall effects of aging.
• Any woman who is considering HRT needs to talk to a physician who knows her medical history.

Uses of hormone replacement therapy

Estrogen and progesterone are important hormones in the reproductive system of a woman. Estrogen produces the release of eggs and progesterone prepares the womb for egg implantation.

Being a natural part of the process, the supply of eggs reduces over time. So, as the number of eggs fall, the production of estrogen will diminish too.

Most women begin experiencing some changes in the hormone levels during their late 40s which can cause hot flashes and other problems.

• Perimenopause – Woman can continue to menstruate for sometime though the changes are taking place. This is known as perimenopause that may last from 3 to 10 years. But the duration is 4 years, on an average.
   
• Menopause – When your last period occurs which is at 51 years on an average, the woman is in menopause.
   
• Postmenopause – A year after the last period, menopause ends and thus, the woman enters into the postmenopausal stage. Symptoms usually decline within 2 to 5 years, but it may take 10 years or more than that.

The increased risk of osteoporosis may even continue after menopause. Other thanthe natural aging process, menopause might be triggered by a hysterectomy that includes removal of ovaries or treatment of cancer. Smoking may speed up the arrival of menopause.

Effects of Menopause

Changing hormone levels can be the reason for severe discomfort and health risks. The following may take place:

• dryness in the vagina
• bone thinning or osteoporosis
• urinary problems
• hot flashes and night sweats
• moodiness
• lower fertility
• thinning hair
• sleep problems
• irregular periods
• concentration and memory difficulties
• smaller breasts and an accumulation of fat in the abdomen area

Can hormone replacement therapy lead to cancer?

HRT had been used widely for lessening the symptoms of menopause and protecting against cardiovascular disease and osteoporosis.

However, its benefits had been questioned after two studies with data from the Women's Health Initiative (WHI) that had been published in 2002 and 2003. Certain findings have linked HRT to breast, endometrial and ovarian cancer.This has led many people to think again about the usage of HRT and so, it is less widely used.

According to studies, it has been found that the benefits of HRT might outweigh the risks,however there is still some kind of confusion. Other studies have suggested that it might:

• improvethe function of muscles
• lessen the risks of heart attack and heart failure
• lower mortality in younger as well as postmenopausal women
• effective in preventing skin aging, if used cautiously by some women

So, HRT might not bedangerous for some women after all. Presently, it has been approved for the treatment of menopausal symptoms and to treat or prevent osteoporosis.

However, anyone who wants to useHRT,must be extremely careful and make an informed decision by discussing everything with theirgynae expert at the private gynaecology clinic in London who actually understands the risks of the individuals.

Since aging is a natural process, hormonal replacement therapy can protect against some changes that take place in women but cannot prevent all the aspects of aging.

Who should not use it?

HRT might not be suitable for women who have past record of:

• high blood pressure or uncontrolled hypertension
• severe migraines
• blood clots or thrombosis
• stroke
• heart disease
• endometrial, breast or ovarian cancer

The risk of breast cancer has risen if hormone replacement therapy is used for more than 5 years. The risk of blood-clotting or stroke problems is not high for women who are within 50 to 59 years.

It should not be used by women who are or may get pregnant.One fear about HRT is that women will gain weight often around menopause, but research has shown that this is not necessarily due to HRT.

Other reasons for weight gain during this time are a drop in physical activity, an increase in appetite due to a fall in estrogen and a redistribution of fat when the hormone levels change. By following a healthy diet and doing regular exercise, you can reduceweight gain.

Types

Common kinds of HRT use different combinations and delivery of hormones.

• Estrogen-only HRT – Women who have had a hysterectomy where their ovaries, uterus or womb have been removed and they don’t need progesterone.
   
• Cyclical or sequential HRT – Women who are menstruating but have perimenopausal-like symptoms may use it. The cycles can be monthly with an estrogen plus progestogen dose during the end of menstrual cycle for 14 days or daily dose of estrogen and progestogen for 14 days in every 13 weeks.
   
• Continuous HRT – This can be used at the time ofpostmenopause. The patient has to take a continuous combination of progestogen and estrogen.
   
• Long-cycle HRT – This can lead to withdrawal bleeding in every 3 months and the safety has been describedas "questionable."
   
• Local estrogen: This includes creams, rings or vaginal tablets that help with urogenital problems such as – dry vagina and irritations.

How does the patient take HRT?

The gynaecologist in London prescribes the lowest possible dosage for treating the symptoms. This may take some trial and error. Some ways to deliver HRT are the following:

• creams or gels
• skin patches
• tablets
• vaginal rings

When you do not require HRT anymore, you can stop using it gradually.

Some alternatives

A woman who suffers fromperimenopause can use other ways to ease its symptoms.These include the following:

• Reduce the consumption of alcohol, caffeine and spicy food
• Quit smoking
• Exercise regularly
• Wear loose clothes
• Sleep in a well-ventilated and cool room
• Add a fan to the bedroom, pillows or cooling gel pad

There are certain SSRI-type antidepressants that may treat hot flashes and the antihypertensive drug, clonidine can also be of great help.

Thus, hormone replacement therapy is considered to be an effective treatment for different symptoms such as hot flashes and sweating. However, women need to consult with the best gynaecologist in London and consider carefully before taking it.