HRT Therapy

Hormone replacement therapy (HRT) is one of the most effective ways to relieve severe menopause symptoms.

After menopause, when your periods have stopped, your body doesn’t produce as much estrogen. For many women, the absence of estrogen brings on a host of unpleasant symptoms like hot flashes, vaginal dryness, and painful sex to name a few.

Menopause is a natural phase, and symptoms eventually subside for most women. But for some, symptoms are severe enough that they need hormonal intervention.

HRT may even offer protection against heart disease and bone loss from osteoporosis but that doesn’t mean HRT is completely risk-free. Whether it’s right for you depends on your age, when you entered menopause and other risk factors.

Here’s a look at the risks and rewards to help you decide whether HRT is a good option for you.

What is hormone replacement therapy?

Hormone replacement therapy involves taking medication when your hormone levels drop. It contains:

• estrogen (or estradiol, the most common form of the hormone in your body);
•  progesterone;
• or both of these hormones.

HRT has a controversial history. Popularized in the 1960s as a way to stay youthful after menopause, HRT use peaked in the 1990s.

Newer studies have shown that HRT has lower risks and more benefits for women who start treatment before age 60 and within 10 years of menopause.

But many people are still hesitant to use HRT because of concerns about the risks it could pose.

What are the benefits of hormone replacement therapy?

Although there’s still confusion about HRT, many researchers say the benefits outweigh the risks. Let’s look at some of the best-researched benefits of HRT.

Alleviates menopause symptoms

The experience of menopause is different for everyone. Some people have symptoms that are so mild no medical treatment is needed.

For others, the symptoms can be so severe that it interferes with their ability to go about their daily life. In this situation, it’s usually a good idea to talk with a doctor about hormone replacement.

HRT may help ease menopause symptoms in the following ways:

• Low-dose estrogenTrusted Source can relieve vasomotor symptoms such as hot flashes and night sweats.
• Low-dose estrogenTrusted Source (in many forms) relieves genital and urinary symptoms of menopause, including vaginal dryness, painful sex, and urinary problems.
• Prasterone and Ospemifene, two other hormone-based treatments, can also relieve genital and urinary symptoms.
• Offers protection against cardiovascular disease

Numerous studies have confirmed that when HRT is started early, within 10 years of menopause, it can help protect your heart and vascular system from disease.

Before starting HRT, it’s important to undergo a physical exam to be sure you don’t already have signs of cardiovascular disease. Your doctor will likely want you to have a check-up every year while you’re on HRT to be sure you’re maintaining good heart health.

Helps ease depression

During the transition into menopause, which can last several years, many women experience some depression.

Estrogen delivered through a skin patch has been proven effective in easing symptoms of depression. There isn’t any evidence so far that estrogen can relieve depression after menopause.

Helps protect your bones

Menopause increases the risk of bone loss, osteoporosis, and fractures.

Research shows that 1 to 2 years of estrogen-based HRT in the form of a skin patch may help improve bone density and protect the structure of your bones as you get older.

Prevents loss of muscle mass

As you age, you tend to lose muscle mass. You need muscle mass for mobility, strength, and balance.

HRT can help prevent the loss of muscle. When combined with exercise, HRT may help increase muscle mass and strengthen your muscles.

Helps prevent Alzheimer’s disease and Parkinson’s disease

According to a 2020 meta-analysisTrusted Source, estrogen-based HRT may have a protective effect against some neurological conditions.

In particular, it may play a role in decreasing the risk of Parkinson’s disease and Alzheimer’s disease.

Who does benefit the most?

Women under the age of 60, or who entered menopause in the last 10 years, stand to benefit most from hormone therapy.

For older women or women who started menopause more than 10 years ago, the risks could outweigh the benefits.

Because of the possible risks, health experts recommend the lowest possible HRT dose for the shortest period of time for people over 60 or who are 10 years past the onset of menopause. The risk is highest for women who use HRT longer than 5 years.

Types of hormone replacement therapy

The Food and Drug Administration (FDA) has approved several categories of HRT. They include:

• estrogen-only products;
• progesterone-only products;
• products that combine estrogen and progesterone;
• products that combine estrogen with other medications.

These hormone medications come in several different forms, such as:

Creams and rings supply hormones to a localized area, which helps to limit the amount in your system.

Who should avoid hormone replacement therapy?

According to the FDATrusted Source, you may want to avoid taking HRT if you’ve had:

• problems with vaginal bleeding;
• breast cancer or uterine cancer;
• blood clots;
• a heart attack or stroke;
• a bleeding disorder;
• liver disease;
• allergic reactions to medications containing hormones.

Talk with your doctor about whether estrogenTrusted Source is right for you, if you have:

• a history of smoking;
• gallbladder disease;
• ovarian cancer;
• migraine headache;
• seizure disorder;
• high blood pressure;
• endometriosis;
• hyperlipidemia (excess fat in your blood);
• uterine fibroids.

Tell your doctor about:

• any health conditions such as cancer, heart problems, liver disease, or blood clots;
• whether or not you’ve ever smoked;
• medications you’re taking for other conditions;
• allergies;
• side effects you’ve had from other hormonal treatments.

The bottom line

While menopause is a natural change, it does involve a drop in your estrogen levels. This can trigger various symptoms which, in some cases, can be severe.

Hormone replacement therapy (HRT) may help ease many symptoms of menopause, including hot flashes and vaginal dryness. It may also lower your risk of heart problems, protect your bones and muscles, and reduce depression.

HRT, however, is not without its risks, especially for women over 60 or who started menopause more than 10 years ago.

Talk to our healthcare professional about whether HRT is right for you and whether the benefits outweigh any potential risks.