Menopause can be a time of irritating symptoms for most women. These include weight gain, hot flashes, night sweats, and much more. While a quarter of women have severe symptoms, only a small proportion of menopausal women currently take hormone replacement therapy (HRT). Symptoms of menopause last far longer than most women anticipate.
HRT is an effective treatment for the typical menopause-related symptoms but it also helps with the long-term health problems associated with the menopause – the risk of osteoporosis, cardiovascular disease, and stroke. HRT involves the administration of synthetic estrogen and progestogen to replace a woman’s depleting hormone levels and thus alleviate menopausal symptoms. Alleviating these symptoms helps women to continue to live their best lives, without the suffering that menopause can cause.
Types of HRT
Common types of HRT use different combinations and delivery of the hormones. While we will prescribe the lowest possible dosage to treat your symptoms, the process may take some trial and error. HRT can be in the form of creams, gels, vaginal rings, tablets, and skin patches. When HRT is no longer necessary the client will stop using it gradually. Here are the different kinds of HRT:
- Estrogen-only HRT
- Women who have had a hysterectomy where their uterus, or womb, and ovaries have been removed do not need progesterone.
- Cyclical, or Sequential HRT
- Women who are still menstruating but have perimenopausal-like symptoms can use Cyclical or Sequential HRT. Cycles may be monthly, with an estrogen plus progestogen dose at the end of the menstrual cycle for 14 days, or a daily dose of estrogen and progestogen for 14 days every 13 weeks.
- Continuous HRT
- A women may use Continuous HRT during post menopause. The client takes a continuous combination of estrogen and progestogen.
- Long-Cycle HRT
- Long-Cycle HRT causes withdrawal bleeds every 3 months. Its safety has been described as “questionable.”
- Local estrogen
- This includes vaginal tablets, creams, or rings. It can help with urogenital problems, including dry vagina and irritations.
Why Choose HRT?
HRT is useful because Progesterone and estrogen are important hormones in a woman’s reproductive system. Estrogen stimulates the release of eggs, and progesterone prepares the womb for egg implantation. As a natural part of the life process, the supply of eggs diminishes over time. As the number of eggs falls, so does estrogen production.
Most women will start to experience these changes in hormone levels during their late 40s. This can lead to hot flashes and other problems. HRT can bring relief to the following:
- Vaginal dryness
- Bone thinning, or osteoporosis
- Urinary problems
- Thinning hair
- Sleep problems
- Hot flashes and night sweats
- Lower fertility
- Irregular periods
- Concentration and memory difficulties
How to Begin HRT
Speak to your doctor if you are interested in starting HRT. You can normally begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. Your doctor can explain the different types of HRT available and help you choose one that is suitable for you. You will usually start off on a low dose, which we can increase at a later stage.
It may take a few weeks to feel the effects of treatment and there may be some side effects at first. Your doctor will normally recommend trying treatment for three months to see if it helps. If it does not, they may suggest changing your dose or changing the type of HRT you are taking.
Weighing Benefits & Risks
There is no single way to ensure the best possible quality of life around menopause and beyond. Each woman is unique and must weigh her discomfort against her fear of treatment. While there is some risk, it is only as the possibility or chance of harm and not that there will be any harm. Medical professionals modify their views about the role of hormones as professionals in the scientific field conduct more research.
Experts agree that there is much they still have to learn. Although recent studies have provided some clarity for large populations, they don’t necessarily address all of the issues an individual woman faces. Only she, with the counsel of her healthcare providers, can do that. Many factors will be part of a woman’s decision to use a particular hormone product—her age, her risks, her preferences, available treatment options, and the cost of the product.
Only after examining and understanding her own situation and after a thorough consultation with her clinician can a woman make the best treatment choice. As new therapies and guidelines are available, and as a woman’s body changes over time, reevaluation and adjustments should be made.
If you would like to learn more about hormone replacement therapy and the various treatments we provide, call (310) 907-8465 to schedule a consultation.