Hormone Replacement Therapy (HRT) as the name suggests, is the use of synthetic hormones to replace declining levels of hormones in the human body. It is most commonly used to treat the symptoms of menopause in women. The therapy can use estrogen alone, in which case it is known as Estrogen Replacement Therapy (ERT). It can also be combined with progesterone in the form of progestins or synthetic progesterone.
The use of HRT has declined considerably in recent year owing to concerns about its safety, with the risks seeming to far outweigh the benefits.
Estrogen can be given in different forms such as pills, vaginal creams, vaginal ring inserts, dermal patches and skin gels. Progestin can be given as a pill (combined with estrogen), an intra-uterine device (IUD), vaginal capsule, injection, implant or a skin gel.
HRT is usually prescribed to treat symptoms of menopause in women. For women who have had a hysterectomy (removal of the uterus), estrogen alone may be prescribed. This is because estrogen alone increases the risk of uterine cancer. Women who still have their uterus are given estrogen in combination with progesterone since the latter lessens this risk.
For the treatment of vaginal dryness experienced by menopausal women. For this purpose vaginal tablet, vaginal rings or vaginal creams are the most beneficial.
For the treatment of hot flashes during menopause. For this purpose, pills and patches are usually prescribed
To avoid monthly vaginal bleeding during the perimenopausal phase. Small doses of estrogen and progesterone are taken every day in the form of a pill. This is known as daily continuous therapy. This therapy can at times result in sudden, irregular vaginal bleeding especially in the case of younger women as they approach menopause. In such cases, doctors usually prescribe progesterone & estrogen pills for the first twelve days of the monthly cycle.
To treat sleep disturbances during menopause.
To reduce the risk of osteoporosis and related fractures. Estrogen is important for the health of bones and when this hormone is not available in the body during menopause, it can adversely affect the health of the bones leading to osteoporosis. However, the risks of using long term HRT for women in the high risk category far outweigh the potential benefits. Women who are at higher risk of or have developed osteoporosis should consult their doctors about alternative therapies to deal with their condition.
To reduce the risk of developing colorectal cancer
For the treatment of Turner’s syndrome. HRT is used to treat women with this rare genetic disorder.
To reverse the gradual decline in testosterone levels in men. Testosterone therapy in the form of gels and patches are used by several men in an effort to increase their sex drive. However, there are concerns over the safety of this therapy.
The long term use of HRT by women can increase the risks of developing gastroesophageal reflux disease (GERD), breast cancer, strokes and heart attacks. Women who suffer from unexplained vaginal bleeding, liver disease, kidney disease, elevated triglyceride levels, or have a history of stroke, breast or uterine cancer, blood clots in the veins and cardiovascular disease are usually not advised HRT.
You should discuss all options as well as risks with your doctor before deciding to opt for HRT.