What exactly is Hormone Replacement Therapy(HRT)?
Hormone replacement therapy (HRT) is a treatment program in which a woman takes estrogen with or without progestin (a synthetic form of progesterone). To decrease the risk of uterine cancer in women who have a uterus, progestin is usually prescribed with estrogen.
What are the benefits of Hormone Replacement Therapy(HRT)?
Benefits of hormone replacement therapy for post-menopausal women, include improvements in some of the most common menopause symptoms such as:
- hot flashes
- mood swings
- vaginal dryness
- dry skin
- irritable bladder symptoms
Other Benefits of HRT include:
- Increased elasticity of the blood vessels, allowing them to dilate (widen) and let the blood flow more freely throughout the body
- Decreased risk of osteoporosis and fractures (broken bones)
- Decreased incidence of colon cancer
- Possible decreased incidence of Alzheimer’s disease
- Possible improvement of glucose levels
Is Hormone Replacement Therapy(HRT) safe?
Short-term hormone replacement therapy is safe for most menopausal women who take HRT for symptom control. However, before HRT is prescribed, make sure you review your medical history with your health care provider. Together, you and your health care provider can decide if you have conditions or inherited health risks that would make HRT unsafe for you.
One of the major signs that you should not have HRT is unexplained vaginal bleeding. If you are most menopausal and have unexplained vaginal bleeding you should seek medical attention with a qualified provider immediately.
HRT is not recommended for women who have:
- History of prior heart attack or stroke and/or increased risk for vascular disease
- Unexplained vaginal bleeding
- Active or past breast cancer
- Fibrocystic breast disease
- Active liver disease
- Endometrial cancer
- Gall bladder disease
- High risk for blood clots or a history of blood clots
What are the risks of Replacement Therapy(HRT)?
The health risks of HRT include:
- Increased risk of endometrial cancer (only when estrogen is taken without progestin) For women who have had a hysterectomy (removal of the uterus), this is not a problem.
- Increased risk of breast cancer with long-term use
- Increased risk of cardiovascular disease (including heart attack)
- Increase in inflammatory markers (such as C-reactive protein)
- Increased risk of blood clots and stroke, especially during the first year of use in susceptible women
What should I do to reduce my risks?
All women taking hormone replacement therapy should have regular gynecological exams (including a PAP smear).
The American Cancer Society recommends that women over age 50 should:
- Perform breast self-examination once a month;
- Have a breast physical examination by her health care provider once a year; and
- Have a mammogram once a year.
Embry Women’s Health always has the safety of our patients as our number one priority. As such we have guidelines for our patients being treated for Hormone Replacement Therapy that exceed industry standards.
Embry Women’s Health HRT Guidelines:
- Annual Well Woman Exam including a breast and pelvic exam
- Pap Smear (If appropriate every 1 to 3 years depending on risk)
- Annual Mammogram (If appropriate based on age and risk. Not all women meet criteria for annual requirement)
- Bone Density Screening – DEXA (Appropriate based on age and risk factors)
What are the side effects of Replacement Therapy(HRT)?
About 5 to 10 percent of women treated with HRT have side effects.
Mild side effects commonly include:
- breast tenderness,
- fluid retention and
- mood swings.
In most cases, these side effects are mild and do not require the woman to stop HRT therapy.
If you do have side effects from HRT, it is an indication to talk to your provider. Adjustments can be made to the type and dosage of estrogen and/or progestin to reduce or eliminate side effects.
If you have a uterus and take progestin, monthly vaginal bleeding is likely to occur. If it will bother you to have your monthly menstrual cycle, discuss this with your health care provider.
Is Replacement Therapy(HRT) the same as birth control?
No. Although women who take birth control pills are also taking estrogen and progestin, the effect is not the same. Women who take birth control pills have not been through menopause and need higher levels of hormones to prevent ovulation. HRT is not a high enough strength to stop ovulation.
After menopause, estrogen levels are low and HRT is used at a low dose to restore hormone levels to a more normal level.
How do I decide if Replacement Therapy(HRT) is right for me?
Even the best candidates for HRT need to periodically evaluate if HRT is the right treatment for them. You should discuss your medical history and risk factors, as well as how HRT can be tailored to your needs with your provider.
Here are questions to consider and ask while meeting with your provider about Replacement Therapy(HRT):
- Am I experiencing difficult menopause symptoms?
- Do I have any medical conditions or a family history of certain conditions that might make HRT beneficial for me?
- Do I have any medical conditions or a family history of certain conditions that might make HRT riskier for me?
- Have I considered alternatives to HRT?
Schedule an appointment to see if HRT can help you reduce symptoms of menopause and help you live a higher quality of life. Night Sweats, hot flashes and mood swings are not a curse that you have to live with. Call us or click here to schedule an appointment with a caring provider, who has experienced menopause first hand and can help you live a better life.
Unexplained Vaginal Bleeding
If you are experiencing most menopausal unexplained vagianl bleeding you need to seek help right away. Most menopausal unexplained vagainal bleeding is the most common symptom of endometrial or uterine cancer. It can also signal vaginal or cervical cancer. Our providers are trained, compassionate women who can help figure out if something abnormal is going on and guide you to finding the right answer. DO NOT put off seeking help for this.
- American Heart Association. Menopause.
- American Heart Association. Postmenopausal Hormone Replacement Therapy and Cardiovascular Disease in Women.
- National Heart Lung & Blood Institute. Postmenopausal Hormone Therapy.
- Writing Group for the Women’s Health Initiative Investigators. Risks and Benefits of Estrogen Plus Progestin in Healthy Postmenopausal Women: Principal Results From the Women’s Health Initiative Randomized Controlled Trial. JAMA. 2002;288:321-333.