Hormone Replacement Therapy: When Do I Need It?

What is Hormone Replacement Therapy?

Hormone replacement therapy (HRT) is a treatment many doctors use to treat or alleviate many symptoms of menopause and andropause. HRT contains bioidentical hormones, and works to replace the estrogen and progesterone the body stops making during menopause. HRT is most commonly taken in pill form, but is available in creams, gels, patches, sprays, or vaginal rings. As with many medications and treatments, there are risks associated with HRT.  These risks vary depending on the type, dosage, duration, and an individual’s personal health risks. HRT should be individualised so that the risks are outweighed by the benefits.

Different Types of Hormone Replacement Therapy

Systemic hormone therapy and low-dose vaingal products are the two main types of HRT. Systemic hormone therapy can treat the common symptoms of menopause. Low-dose vaginal products can be used to treat the vaginal and urinary symptoms of menopause. The form of HRT taken depends on the individual; as a woman who has taken a birth control pill before might feel more comfortable taking a pill daily, but others might prefer a cream depending on their symptoms. These products also have different dose frequency; some are daily, weekly, or monthly. It is important for an individual to choose a product that works best for them, HRT is not a “one size fits all” product.

Hormone Replacement Therapy Risks

There is controversy and risks surrounding HRT, and doctors have different opinions on the effectiveness. In 2002, the Women’s Health Initiative published a study that found HRT is associated with a high risk of blood clots, breast cancer, heart disease, and strokes. However, new studies have suggested these risks depend on age, type of HRT, and health history. The Women’s Health Initiative study has made doctors more hesitant to prescribe HRT, and the FDA recommends that if women use HRT to use the smallest dose possible for a short amount of time. The American Cancer Society also recommends that a woman’s risk for certain cancers and conditions needs to be taken into consideration before prescribing HRT.

Hormone Replacement Therapy Benefits

Although many have concerns that HRT can cause more health concerns, many of those concerns are connected to synthetic hormones. Bioidentical hormones, also known as natural hormones, are plant-based and are made to be molecularly identical to the hormones your body naturally produces which significantly helps to lower risks of health concerns. 

Symptoms that come along with aging and menopause can cause large amounts of discomfort that can negatively affect many aspects of life. 

“As women reach menopause, they can experience increased stress and anxiety, difficulty sleeping, fatigue, low energy, and a low sex drive,” says Dr. Edward Jacobson MD of the Greenwich Hormone Replacement Therapy Center. “Bioidentical HRT can not only help alleviate symptoms of menopause to provide for a more energetic and comfortable life, but it can also proactively protect your health.”

When it comes to hormone replacement therapy, the goal is to balance out hormone levels based on the symptoms you are experiencing. As an example, if you are experiencing a noticeable loss of energy and insomnia, estrogen hormone replacement might be used rather than sleeping pills to help restore your natural sleeping patterns.

Along with the quality of life improvements, HRT has been the subject of many medical studies. In these studies, they have proven that those who use HRT have seen a reduction in the risk of heart disease, stroke, vascular dementia, Alzheimer’s disease, and diabetes.

When Should Women Start Hormone Replacement Therapy?

Over 44% of post-menopausal women have reported using HRT. It is recommended that women, if they choose to take HRT, start within 10 years of their last period. HRT should not be used just because a woman is in menopause, but should only be used if a woman has bothersome symptoms regularly. If a woman goes on HRT, she should be re-evaluated every five years until she reaches her 60’s then she should be evaluated once a year. If women are having severe menopause symptoms they should reach out to a doctor to discuss options. It is important to reach out to and talk to your healthcare provider to go over options if you are considering hormone replacement therapy.

Richard Buckley