Overview of Hormone Replacement Therapy

    Hormone therapy is a treatment for women going through menopause.

    The hormones estrogen and progesterone help regulate a woman’s menstrual cycle. They also play an important role in bone health and support other functions in a woman’s body.

    As a woman goes through menopause, her levels of estrogen and progesterone drop. This can cause hot flashes, night sweats, and sleep disturbances. Hormone replacement therapy (HRT) can help ease these symptoms. The therapy uses estrogen by itself or with progestin, the synthetic version of progesterone.

    HRT can also be used to treat conditions that disrupt normal production of estrogen and progesterone, such as premature ovary failure. This therapy is effective for some women. However, for others, the risks may outweigh the benefits.

    Hormone replacement therapy is also known as estrogen replacement therapy (ERT). A different type of hormone therapy exists for men who have breast cancer.

    The Risks of Hormone Replacement Therapy

    The National Institute of Health (NIH) under the Women’s Health Initiative conducted a major trial that tested continuous estrogen-plus-progestin HRT for post-menopausal women. The study found that the estrogen-plus-progestin supplements resulted in (NIH, 2004):

    • an increased risk of dementia, heart attack, stroke, blood clots, and breast cancer
    • reduced risk of colorectal cancer
    • fewer bone fractures

    Researchers found that this therapy put post-menopausal women at risk for severe health problems. They stopped the trial to protect the women’s health. However, the risk and benefits to women with other conditions affecting their hormone levels may be different. Discuss your risks with your doctor before you consider HRT.

    How to Prepare for Hormone Replacement Therapy

    Talking with your doctor about hormone therapy is the first step in discovering if it’s right for you. According to the Mayo Clinic, the benefit of HRT may outweigh the risks for healthy women if they (Mayo, 2012):

    • experience moderate to severe hot flashes
    • have lost bone mass and other treatments aren’t working
    • suffer from premature menopause (stopped menstruating before 40)
    • lost function of the ovaries at a young age

    How Hormone Replacement Therapy Is Performed

    HRT is a short-term therapy for menopausal symptoms. Therapy typically lasts one to two years. It may last longer than five years for conditions such as premature ovarian failure.

    HRT can be delivered via:

    • oral tablets taken daily
    • injections (rarely used)
    • intrauterine devices, such as rings or implants
    • patches that slowly release hormones
    • transdermal gels
    • vaginal rings

    Talk to your doctor about which delivery option would be best for you. You should not undergo HRT if you smoke.

    After Hormone Replacement Therapy

    As you begin HRT, you’ll notice your menopausal symptoms decrease in severity or stop completely.

    Your doctor may adjust your dosage levels in follow-up appointments. Women should only take the lowest dose of hormones to prevent problems.

    Menopausal women should adopt a healthy lifestyle, including:

    • regular exercise
    • eating a healthy, balanced diet
    • maintaining a healthy weight
    • limiting alcohol consumption
    • managing stress

    Contact your doctor if you have any questions or concerns during your therapy.