Hormone replacement therapy (HRT) is an important treatment option for menopause and other medical conditions. For women who are considering HRT, it’s important to understand how the therapy works and get your questions answered. Below are answers to some of the most frequently answered questions.
What is HRT?
HRT involves taking estrogen, a naturally occurring hormone produced by the body. If a patient still has a uterus, progestin is also administered; estrogen-progestin treatment is called combined therapy.
What does HRT treat?
HRT is primarily used to treat the symptoms of perimenopause and menopause, including menstrual cycle changes in frequency and flow , hot flashes, vaginal dryness, urinary tract changes including more frequent urination, and bone loss. HRT can also delay the onset of menopause in some cases.
What are the benefits of HRT?
HRT is effective in relieving night sweats and hot flashes, vaginal dryness and bone loss. HRT helps prevent spine and hip fractures and may help prevent colon cancer.
What are the risks of HRT?
Estrogen-only HRT causes the uterine lining to grow and may increase the risk of uterine cancer though adding progestin reduces this risk. HRT may contribute to an increased risk of heart attack. HRT is associated with a slightly increased risk of stroke, deep vein thrombosis, breast cancer and gall bladder disease.
How is HRT delivered?
There are two types of HRT. Systemic therapy released hormones into the bloodstream, which delivers them to organs and tissues. Systemic estrogen comes in skin patches, pills, gels and sprays applied to the skin. Progestin, if needed, can be given separately or in a combined pill or patch form.
Local therapy is often used for treating vaginal dryness. A vaginal ring, cream or tablet of estrogen is inserted. The estrogen is released in small doses into the vaginal tissue, helping restore elasticity and thickness while relieving dryness and irritation.
How frequently are treatments taken?
For estrogen-only therapy, the hormone is taken every day or every few days. With combined therapy, treatment can be done daily or cyclically, with estrogen taken every day and progestin added a few days every month or every 3-4 months.
What are the side effects?
The most common side effects are vaginal spotting, heavier bleeding (like that of a menstrual period), fluid retention and short-term breast soreness. While bleeding is an expected side effect, any postmenopausal bleeding should be reported to a physician.