Knowing the pros and cons of hormone replacement therapy (HRT) can help you decide which one is right for you.
Menopause is a natural event that every woman will go through at some point. This should not bring any problems, however, it is common to develop one or more symptoms, which are due to the low level of oestrogen. Dr. Romerico Torres and Prudence Aquino-Aquino explain that a woman becomes menopausal when her ovaries cease to produce the hormone oestrogen and outwardly manifests with cessation of menses for at least a year. Hormone replacement therapy or HRT is given to menopausal women to treat their vasomotor symptoms such as hotflushes, sweting, moodiness, urogenital dryness.
What is hormone replacement therapy?
HRT is a treatment used to augment the body’s natural hormone levels, either in the form of estrogen-alone therapy (ET) for women who have had a hysterectomy, or as estrogen with progesterone therapy (EPT) for women who experience menopause naturally at midlife.
Why replace hormones?
Oestrogen thickens the lining of the uterus, preparing it for the possible implantation of a fertilized egg. It also influences how the body uses calcium, an important mineral in the building of bones. In addition, it helps maintain healthy levels of cholesterol in the blood. Further, oestrogen is necessary in keeping the vagina healthy.
With the onset of menopause, however, the amount of natural oestrogen and progesterone the ovaries produce drops sharply. This can lead to such symptoms as hot flashes, night sweats, vaginal dryness, painful intercourse, mood changes, and sleep problems.
“HRT also prevents the long term consequences of having very low oestrogen in the body, like thinning of bones, inelastic blood vessels, loss of skin turgor and elevated cholesterol levels,” added Dt. Torres. HRT consists of oestrogen + progesterone and is given in menopausal women with intact uteri. “Those who have undergone hysterectomy are given just oestrogen or just oestrogen replacement therapy or ERT.”
What are the benefits of taking HRT?
HRT is prescribed to relieve :
- Hot flashes
- Vaginal dryness that can result in painful intercourse
- Other problematic symptoms of menopause, such as night sweats and dry, itchy skin
According to The Cleveland Clinic Foundation, other benefits of taking HRT are as follows:
- Reduced risk of developing osteoporosis and reduced risk of bone breakage
- Improvement of mood and overall sense of mental well-being in some women
- Decreased tooth loss
- Lowered risk of colon cancer
- Lowered risk of diabetes
- Modest improvement in joint pains
- Lower death rate for women who take hormone therapy in their 50s.
Different Forms of HRT
HRT comes in different forms. You may need to try different types before finding one that works best for you.
- Tablets – which are usually taken once a day, are one of the most common ways of taking HRT. For some women this may be the simplest way of having treatment.
- Skin patches – are also a common way of taking HRT. You stick them to your skin and replace them every few days. Patches may be a better option than tablets if you think you might find it inconvenient to take a tablet every day.
- Oestrogen gel is an increasingly popular form of HRT. It’s applied to the skin once a day and is absorbed by the body. Like skin patches, this can be a convenient way of taking HRT while avoiding an increased risk of blood clots.
- Implants – can be given using small pellet-like implants inserted under your skin (usually in the tummy area) while your skin is numbed with local anaesthetic, although these aren’t widely available and aren’t used very often. The implants release oestrogen gradually over time and can stay in place for several months before needing to be replaced. This may be a convenient option if you don’t want to worry about taking your treatment every day or every few days.
Different women prefer different methods of taking HRT. For example, some women prefer to wear a patch rather than taking tablets. The more reason you consult your doctor so he/she can give you information about the pros and cons of the different types of HRT
For more information about HRT please visit:
Romerico Torres, MD
FEU-NRMF Medical Center
Room 411 Marian Medical Arts Building
Regalado St., West Fairview, Quezon City, Metro Manila
Prudence C. Aquino-Aquino, MD
St. Luke’s Medical Center
Suite 239 Medical Arts Bldg.
279 E. Rodriguez Sr. Blvd., Quezon City, Metro Manila
North American Menopause Society. The 2012 hormone therapy position statement of the North American Menopause Society
The Cleveland Clinic Foundation (my.clevelandclinic.org, accessed May 12, 2017)
Everyday Health (everydayhealth.com, accessed May 12, 2017)