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Hormone Replacement Therapy

Hormone Replacement Therapy (HRT) refers to either estrogen or combination estrogen/progesterone treatment. HRT is the process, wherein external hormones are administered for the treatment of menopausal symptoms in women. This article provides information on the risks associated with HRT.
Ningthoujam Sandhyarani
Menopause refers to the cessation of the menstrual cycle. Usually, natural menopause happens between the age of 45 to 54. In fact, estrogen and progesterone are the two main sex hormones produced by the ovaries, which regulate menstruation. About 3-5 years before menopause (perimenopause), the functions of the ovaries deteriorate, resulting in the abnormal production of the sex hormones. Hormone levels go up and down, thus disturbing the normal menstrual cycle. Lack of estrogen also increases the risk of osteoporosis and heart diseases. Overall, many problems are observed at the time of menopause.
Some of the symptoms of menopause are irregular menstruation, hot flashes (feeling of intense heat with rapid heartbeat and sweating), vaginal dryness, fat redistribution, and sometimes depression, and lack of concentration. Symptoms can be mild or severe and may last for several months to even years. These symptoms can be treated with Hormone Replacement Therapy (HRT), wherein a group of medications is prescribed for supplementing hormone levels, so as to restore the hormonal functions of the body.
HRT refers to the therapeutic use of exogenous hormones in order to substitute the hormones that the body fail to produce naturally. Generally, it is used to treat menopausal symptoms in women, resulting from abnormal production of sex hormones. It is also called menopausal hormone therapy or estrogen replacement therapy. Other benefits of HRT include preventing osteoporosis, maintaining skin thickness, and reducing wrinkles.
Estrogen and progesterone hormones are used in this therapy. Progestin refers to synthetic progesterone that can be used instead of progesterone. For women who have undergone hysterectomy (removal of uterus), only estrogen is prescribed, which is why the therapy is referred to as an unopposed estrogen therapy. In case of women who have not undergone hysterectomy, estrogen in combination with progesterone is prescribed.
The dosage of the hormones can be taken in two ways - sequentially combined and continuous combined. In the former, estrogen is taken everyday and progestins are taken 10-14 days for every month or two, whereas both hormones are taken daily without any breaks in case of the latter. Hormones can be administered in many ways depending upon the specific purpose of use. Some of the common forms in which the hormones are used include tablets, gels, creams (progesterone cream), and vaginal rings. They can also be given via skin patches or intrauterine devices (IUDs), and sometimes through injections.
Risks
Studies conducted in 2002 have shown that HRT is associated with certain risks, such as breast cancer, ovarian cancer, vaginal bleeding, liver diseases, stroke, and heart attack. These risks vary as per the lifestyle and medical history of the woman. Other common adverse effects include weight gain, breast enlargement, mood swings, skin irritation, nausea, and headaches.
It is observed that this therapy usually provides relief from the symptoms of menopause for about one to two years. For women who have undergone oophorectomy (surgical removal of ovaries) or premature ovarian failure, HRT can be administered till the normal age for the onset of menopause.
One should be aware of the benefits and the risks associated with HRT. It is advisable to consult and seek advice from a physician before deciding. Also, it is recommended to take lower doses for a minimum period, as it has been suggested that the risks of HRT outweigh its benefits in some women.
Disclaimer: This article is for informative purposes only and does not in any way attempt to replace the advice offered by an expert on the subject.