As women grow older, their ovaries shrink in size and stop producing estrogen. In the US alone, around 1.3 million women enter the menopausal stage of their lives annually. This stage is not very simple as it comes with its discomforts in the form of vaginal dryness, insomnia, itching, etc. Hormonal Replacement Therapy helps lessen the symptoms of menopause.
What is Menopause?
Every woman goes through menopause, a stage in her life where she loses her reproductive ability i.e., her ovaries stop producing the hormones that assist reproduction. As you grow old, your ovaries decrease the production of estrogen, the hormone because of which you get your period. Once the estrogen production becomes irregular, so does the occurrence of your period– until your period stops completely. So, if you have not had your period in the past year, you have entered menopause.
Menopause is natural and happens around the age of fifty. However, some women get their ovaries removed surgically and face the symptoms that come with menopause early.
As the stage of menopause begins, the normal hormone levels in the body become disrupted, and women experience many different symptoms. These symptoms include:
- Vaginal dryness that hinders intercourse
- Hot flashes that usually occur during the night. You may describe this condition as a sudden rush of warmth all over the body
- Altered libido
- Mood swings
- Urinal urgency. In this scenario, a sudden build-up of pressure in the bladder occurs, making it difficult to hold back the urine.
- You may break out into night sweats
- Sleep gets disrupted, resulting in insomnia
- Dryness or itching in the skin, mouth, or eyes
- Feeling irritated or even feeling depressed
In some people, the lack of estrogen may even result in:
- cardiovascular disease or
- cognitive dysfunction
What is Hormone Replacement Therapy?
HRT (Hormone Replacement Therapy) is a treatment used in medicine that combats the symptoms caused after a woman reaches menopause. It is also known as menopausal hormone therapy or just hormone therapy.
Types of HRT
There are two types of hormone replacement treatments, depending on the hormones administered to the body.
In this case, the therapy includes estrogen only.
Combined Hormone Therapy
Both estrogen and progesterone remain included in this type of therapy. It is prescribed to those women who have not surgically removed their uterus through a hysterectomy.
How Are The Hormones Addressed To The Body?
There are two main ways the hormones are taken.
Systemic Hormone Therapy
The hormone is taken as a pill, patch, or injected into the body. In that way, the hormones enter the bloodstream and reach the target tissue or organ.
Local Hormone Therapy
The hormone is taken as a vaginal cream, ring, suppository, or tablet. The hormone does not enter the bloodstream, and is hence prescribed mainly to women facing vaginal dryness.
Benefits of Hormone Replacement Therapy
There are many advantages of undergoing Hormone Replacement Therapy which helps you manage the symptoms that come with menopause.
- Vaginal dryness, hot flashes, and night sweats are a few of the many symptoms linked to menopause and an HRT will help you relieve yourself of those. In fact, short-term hormone therapy has proven to be the most effective for combating night sweats.
- It helps you sleep better
- Sex becomes less painful as you rid yourself of vaginal dryness. It also elevates the reduced sex drive
- Another benefit of HRT is that it also reduces the chances of osteoporosis or fracturing or thinning of a bone. It also decreases the loss of teeth
- Since estrogen levels affect the serotonin and endorphin levels in the brain, they can alleviate the mood, decreasing the number or extent of mood swings. It may also lessen depression. However, that is related to some women only.
- Joint pains become less painful
- HRT also decreases the risk of diabetes, dementia, heart disease, and colon cancer. According to some studies, women below the age of sixty who have had menopause for ten years and undergo HRT are at a lower risk of heart disease.
- Women in their fifties who undergo HRT have lower death rates
Risks of Hormone Replacement Therapy
While HRT has its advantages, it also comes with a few risks. These include:
- Blood clots in the lungs or the legs could lead to a stroke. Sometimes, even a heart attack may occur
- Another disadvantage of HRT is deep vein thrombosis
- It may result in diseases of the gall bladder or gallstones. The risk of gall bladder increases when you undergo therapy in the form of pills.
- If you start hormone replacement therapy after midlife, the risk of Alzheimer’s disease or dementia increases.
Hormone Replacement Therapy and Cancers
- If you have not surgically removed your uterus and do not have progesterone in your HRT, you may be at risk of endometrial cancer as it leads to the growth of the uterus lining. Progesterone decreases the risk of uterine cancers.
- There is a small but increased risk of breast cancer. For example, if you have been pursuing combination therapy for the past five or more years. I.e., long-term treatment may result in cancers of the breast.
The WHI (Women’s Health Initiative Study) examined 16000 menopausal healthy women for eight years and noticed a significant increase in the occurrence of heart diseases and breast cancer owing to the use of hormone replacement therapy.
Side-effects of HRT
- Spotting or bleeding in the vagina that stops spotting around six months after treatment
- Swelling or tenderness of the breasts
Should I be going for Hormone Replacement Therapy?
A common question women are worried about is whether HRT is safe or not. We have listed the pros and cons of HRT for you. It is best to take the hormone doses in a small amount, weigh down whether it is beneficial for you and whether the benefits outweigh the cons or not, then continue. It is best to refer to a doctor who can guide you better. If you have already started therapy, review it with your doctor annually and get mammograms and pelvic exams regularly.
In certain conditions, you should definitely discard the idea of HRT. These include:
- Breast or endometrial cancer
- The appearance of blood clots
- Diseases of the liver
- Are pregnant or suspect pregnancy
- You notice unexplained vaginal bleeding
- Have had a heart attack or stroke in the past
There are a number of questions you might have, such as:
- Will my medical history come in the way of my HRT?
- Will my family medical history affect my therapy in any way?
- Should I opt for any other treatment instead of HRT?
- What type of HRT should I be pursuing?
Of course, these questions are specific to your health, and consultation may help you answer all your queries. Oftentimes, women find themselves confused as to what their bodies are going through and what they should do about it. The team at Family Medicine Austin helps women make the correct decisions for their bodies, and empowers them through it. If you have any questions or experience any of the symptoms above, book an appointment now.