Chapter 4:
HRT Treatment

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What is HRT?

Hormone Replacement Therapy (HRT) is also now known as Hormone Replacement (HR). Hormone replacement therapy is given to some women to help reduce the symptoms of menopause. The hormones in HRT are either made from plant extracts or from extracts derived from animals. One such artificial hormone comes from equine estrogen, which is derived from the urine of a pregnant horse.

Once a woman reaches menopause, her ovaries are no longer producing the same amounts of the hormones estrogen, progesterone and testosterone as they did during her reproductive years. HRT helps provide the body with these hormones.

  • Estrogen helps maintain good bone density, proper skin temperature and regulates moisture of the vagina.
  • Progesterone helps protect the endometrium (the lining of the uterus). Lack of progesterone may slightly increase a woman’s risk of developing endometrial cancer.
  • Testosterone is the sex hormone. Lower testosterone levels can cause some women to experience a lower sex drive.

Many women are under the impression that, during menopause, their body completely stops producing these hormones. This is incorrect. The fact is, menopause causes the ovaries to produce around forty percent less estrogen, while progesterone levels drop to almost zero. Testosterone levels generally decline around fifty percent.

Many women avoid taking HRT because of what they have heard from other people or what they have read about it. The effects of HRT are still under study, and the results are controversial.

When Is HRT Recommended?

HRT is recommended for women who are suffering severely with the symptoms of menopause. While many women find great relief with HRT, not all women will, and some women will experience side effects.

Women’s bodies all function differently, and so we all experience the severities of menopause symptoms differently. Today there are many different types and brands of HRT to try. If one type of HRT does not work for you, keep experimenting until you find one that suits you and your body.

What Are the Benefits of Taking HRT?

HRT can help reduce the severity of menopause symptoms such as:

  • Hot flashes
  • Night sweats
  • Mood swings
  • Irritability
  • Insomnia
  • Aching joints
  • Vaginal dryness
  • Breast tenderness
  • Low libido
  • Anxiety
  • Depression
  • Anger

HRT can also help guard against osteoporosis and heart disease.

Types of HRT

You cannot purchase HRT over the counter. After discussing the advantages and disadvantages with your health care practitioner, and deciding you will benefit from taking HRT, you will be given a prescription.

There are many different brands of Hormone Replacement Therapy on the market, and they all have their advantages and disadvantages. Some types of HRT contain only estrogen, and others contain estrogen and progesterone combined. You can also take estrogen and progesterone separately, which gives you more control over the dosage of each hormone.

If you decide to take the estrogen and progesterone combined, it will be a set dosage; you will have no choice of amounts you can take.

Estrogen-Only HRT

Estrogen-only HRT is usually recommended for women who have had a hysterectomy. There is no need to take progesterone because there is no risk of endometrial cancer (cancer of the lining of the womb).

Continuous Combined HRT

Continuous combined HRT (estrogens and progesterone) is usually recommended for women who have reached menopause, and have not had a period for a full twelve months straight.

As the name suggests, continuous HRT involves taking estrogen and progesterone every day of the month, without a break. Women can also take a HRT combination of estrogen, progesterone.

Cyclical HRT

When undergoing cyclical HRT, also known as sequential HRT, estrogen is taken every day and progesterone is taken for the last fourteen days of the menstrual cycle. This method is often recommended for women who have menopausal symptoms but are still having their periods.

Testosterone can also be prescribed in many of the forms below.

HRT can be taken in different ways.

  • Tablets
  • Implants
  • Gels
  • Vaginal ring
  • Vaginal creams
  • Cream
  • Injections
  • Patches
  • Pessaries (For local vaginal application.)

How Long Can HRT Be Taken?

It is recommended that you do not take HRT any longer than five years straight. If you have been taking HRT for a long time and you want to see if your menopause symptoms have stopped or eased, you should stop taking it gradually. Consult your health care practitioner if you choose to stop taking HRT. They will be able to monitor you or suggest other alternatives.

If your menopause symptoms have stopped, fantastic! If they have not stopped then you can just start taking HRT again. While on HRT, I highly recommend you get a medical checkup annually, just to be safe.

What are the Side Effects of HRT?

There are always risks and side effects from taking any prescribed medications. You should discuss any concerns you may have about taking HRT with your health care practitioner to see if it is right for you.

Different HRT treatments have different side effects for different women.

Some possible side effects from taking HRT short- and long-term are:

  • Breast cancer
  • Ovarian cancer
  • Uterine cancer
  • Strokes
  • Heart disease
  • Blood clots
  • Dementia
  • Gallbladder disease
  • High blood pressure
  • Liver problems
  • High blood sugar levels
  • Fluid retention

Research shows that women who start to take HRT treatments at the age of sixty or older are at a greater risk of the side effects than women who start to take it at an earlier age.

If you have not found an HRT treatment that is helping you, stay positive. You will find one that suits you. Every woman experiences the results differently, and the severity of menopause symptoms can influence the results of the treatment.

Many women who are suffering severely from menopause symptoms, who are emotionally and physically exhausted and believe they have no quality of life, feel the benefits from HRT well outweigh the risks.

Despite the health risks, HRT treatment is still the most effective treatment for menopausal symptoms.