Hormone replacement therapy can save you a whole lot of suffering if the discomforting symptoms of menopause affect you and keep you from performing in your daily life. The most common symptoms are hot flashes, mood swings, episodes of depression, weight gain in the abdominal area, vaginal dryness, sleep disorders, and more. They have slightly different reasons behind them, but they can nonetheless make life harder for women during this period of life.
As with any medical therapy, there are numerous factors to consider before trying HRT, which can best be determined by consulting your gynecologist.
Benefits of HRT
Hormone replacement therapy effectively decreases the frequency and severity of symptoms such as hot flashes, mood swings, and sleep disturbances. It improves vaginal health and combats vaginal dryness, which leads to a better sex life.
According to the literature, HRT can assist women with postmenopausal symptoms. In addition, research shows that HRT can help some postmenopausal women with selected comorbid conditions such as osteoporosis, type II diabetes, certain cardiovascular pathologies, and colorectal cancer.
The absolute risk of HRT for healthy women under 60 is low, and it can effectively improve the quality of life during and after menopause.
Medical concerns
HRT is a safe way to combat menopausal symptoms for most women between 50 and 59. The most important questions are which type of HRT can be taken safely and which method of administration to turn to? The two types of HRT are estrogen-only and the so-called combined HRT, when the patient takes estrogen and progestin together. Both estrogen and progestin are hormones of the female body (progestin is the synthetic version of the natural hormone progesterone). Estrogen may increase the risk of cancer development in the uterus, which is why doctors recommend most women who still have their uterus to take combined HRT. The progestin in combined HRT acts against the effects of estrogen that might cause cancer growth.
Women with a history of breast cancer, CHD, venous thromboembolism, stroke or active liver disease should avoid HRT. HRT is not recommended for the prevention of cardiovascular diseases and dementia, and its long-term use has been linked to an increased risk of ovarian cancer as well as breast cancer.
The option of choosing HRT for menopausal symptoms is in every case an individual decision that should be based on the patient’s quality of life, health priorities as well as personal risk factors. The latter include age, time since menopause, and the risk of thrombosis, stroke, ischemic heart disease and breast cancer. The consideration of menopausal hormone therapy for symptom relief or osteoporosis prevention should be part of an overall strategy that includes lifestyle recommendations regarding diet, exercise, smoking cessation and safe levels of alcohol consumption for maintaining peri- and postmenopausal women’s health and quality of life.
How to apply?
The type of HRT administration is important too. The two main application methods are oral and transdermal, and they are recommended for slightly different symptoms and conditions. Usually transdermal therapy is the first choice for estrogen treatment, and it is important to note that the risk of stroke and VTE appears to be lower with transdermal than with oral estrogen. Oral, as opposed to transdermal estrogen, increases CRP (C-reactive protein) and triglyceride levels, which increase the risk of cardiovascular diseases as well as SHBG (sex hormone binding globulin) and testosterone levels, possibly leading to loss in libido. Hormone pills, which you have to take orally just as you would do with any other tablet, are available, and this type of administration has especially beneficial effects in cases when the woman has too many male hormones (androgens) in the blood and suffers from increased hair growth as a result. Pills can also be used to combat weight gain and metabolism issues.
Transdermally applicable hormone therapy comes in the form of sprays, gels and patches. This method of application bears a lower risk of thrombosis even in overweight women and may lower the risk of stroke and high blood pressure. Additionally, certain forms of it are the most effective treatment options for vaginal dryness and pain during intercourse.
We are all different
No two bodies are the same, which means there is no therapy suitable for all. As with any other type of therapy, HRT should not be taken without clear indication (the presence of symptoms). If you are thinking of taking HRT, you should consult your doctor first. If you are suffering from the symptoms of menopause, the question is not whether HRT is right for you, but what form of it would suit you best. A stress-free, relaxed life can be ahead of you even during menopause, you just have to reach out to a professional to get it.
References:
• https://pubmed.ncbi.nlm.nih.gov/18042129/#:~:text=Conclusions%3A%20According%20to%20the%20literature,cardiovascular%20pathologies%2C%20and%20colorectal%20cancer.
• https://www.nice.org.uk/guidance/ng23/resources/menopause-diagnosis-and-management-pdf-1837330217413
• https://pubmed.ncbi.nlm.nih.gov/30063464/