Everything You Need to Know About Hormone Replacement Therapy

Hormone Replacement Therapy 101

Hormone Replacement Therapy 101

With contributions from Afra discussing alternative hormone replacement therapy options.

Hormone replacement therapy (HRT) is a useful treatment for menopause symptoms. However, it is also associated with an increased risk for breast cancer. In fact, the use of certain types of HRT can increase the risk of breast cancer by up to 75 percent.

HRT is a treatment option for some women but should not be considered for others. Below, we’ll talk about HRT in detail.

What Is Hormone Replacement Therapy?

HRT is a treatment used for menopausal women.

During menopause, estrogen levels plummet. Due to this drop in estrogen levels, symptoms occur, such as vaginal dryness and hot flashes. HRT is an effective treatment for these symptoms – it is essentially replacing the hormone that is “lost” in the body.

HRT can truly be a “magic” pill for some menopausal women. However, it also carries an increased risk for certain conditions, so it should be used judiciously.

Menopause and Hormones

As we just discussed, menopause occurs when estrogen levels decrease in the body. When we utilize HRT, we are essentially supplementing these hormones.

But what exactly are these hormones? Why are they so important?

Estrogen and progesterone are the two “key players” of the reproductive system. They help to control our menstrual cycles, as well as our fertility. Estrogen thickens the lining of the uterus – this allows for implantation of a fertilized egg. When an egg isn’t implanted, menstruation occurs. Estrogen also “influences how the body uses calcium, an important mineral in the building of bones. In addition, estrogen helps maintain healthy levels of cholesterol in the blood. Estrogen is necessary in keeping the vagina healthy.”


Once this loss of estrogen occurs, symptoms of menopause begin to occur.

And why is progesterone taken, along with estrogen? As we’ll learn below, progesterone is only prescribed to women who still have their uterus – it helps to keep the lining of the uterus thin. When taken this way, it reduces a woman’s risk of developing endometrial cancer.

Types of Hormone Replacement Therapy for Menopause

There are several different types of HRT available.

Systemic Hormone Therapy

Systemic hormone therapy is undoubtedly the most effective type of HRT. Typically an estrogen preparation or estrogen and progestin preparation, systemic HRT is available as a pill, a patch, a gel, a cream, or a spray. It is highly effective in treating hot flashes associated with menopause, as well as night sweats, vaginal dryness, itching, burning, and discomfort with intercourse.

Women who have had to undergo a hysterectomy are often recommended an estrogen supplement. Most women will take this medication as a pill or a patch.

Women who still have their uterus typically will take an estrogen and progestin supplement. Progestin is the synthetic form of the hormone progesterone. This supplement is meant only for women who still have their uterus, and is generally used as birth control.

Low-Dose Vaginal Products

Low-dose vaginal products contain estrogen and are available in a cream, a tablet, or a ring. They typically treat the vaginal symptoms associated with menopause, such as vaginal dryness, as well as urinary symptoms.

In addition, the absorption of hormones is thought to be less when administered vaginally. When given vaginally, HRT does not help with symptoms such as hot flashes and night sweats.

How Does Hormone Replacement Therapy Help Menopause?

Research indicates that certain systemic preparations are protective of the body.

For example, combined estrogen and progestin appears to reduce the risk of colon cancer. It may also reduce cancer of the endometrium.

Estrogen alone may stave off heart disease – but only in the early postmenopausal years. It may also protect against osteoporosis, but bisphosphonates should still be used as the primary treatment for this condition.

Next page: HRT side effects, risks, and what if you can’t take HRT?

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