What Is Hormone Replacement Therapy for Menopause? Benefits & Risks

When you go through menopause, your ovaries lose their reproductive functions. Ovule cells are not produced, the production of estrogen and progesterone hormones decreases. The main cause of postmenopausal symptoms is decreased estrogen levels.
Most women go through this natural phenomenon between the ages of 45 and 55 and this period will cause negative health consequences for most. A lucky few have just mild symptoms, but the rest will experience annoying postmenopausal distress. Typical symptoms include hot flashes, night sweats, anxiety, depressed mood, trouble sleeping, joint pain, and vaginal dryness. These symptoms can negatively affect the quality of your daily life.
The drop in estrogen causes bone loss and increased risk of fractures. Abdominal fat increases even if there is no weight gain. Therefore, the risk of diabetes and heart disease increases. Keep in mind that having only mild menopause symptoms does not mean bone loss and other metabolic changes are not occurring. These basic risks develop silently.
Menopausal Hormone Therapy, also known as Hormone Replacement Therapy (HRT) or Estrogen Replacement Therapy (ERT), is the most effective treatment for menopausal symptoms. Still, many women and healthcare providers are confused about the benefits and risks of it.

What Is Menopausal Hormone Therapy?

HRT replenishes estrogen sources in the body to treat menopausal symptoms. Taking estrogen causes the lining of the uterus to thicken, so progesterone is added to the treatment to stop this. This is important because a thickened uterine lining can have the potential to develop into uterine cancer. For a woman who has had a hysterectomy (removal of the uterus) however, estrogen alone will be sufficient for treatment. Estrogen is usually taken in tablet form, but can be applied as a skin patch or skin gel. Progesterone is taken as a capsule. There are a number of single formulations and combinations, so the dose and formulation of treatment should be adjusted by a gynecologist according to the health status and personal preferences of each woman.
Hormone Replacement Therapy should not be taken if you have an estrogen-sensitive cancer such as breast cancer or undiagnosed vaginal bleeding. Unless there is a specific reason, it is especially important for women with premature menopause to take HRT. It should be used regardless of how severe the symptoms are. Menopause before age 45 is classified as premature menopause. Women with premature menopause are at greater risk for osteoporosis, heart disease and premature death.

Balancing Risks and Benefits

Women receiving treatment are less likely to have abdominal fat and diabetes. HRT prevents bone loss and thus the risk of fracture that persists after treatment is stopped. Estrogen alone reduces the risk of heart disease, while estrogen and progesterone together reduce the risk of colon and uterine cancer.
Some women using HRT may need to continue treatment for five or ten years to manage their symptoms. More than 40% of women aged 60 to 65 may still have hot flashes and night sweats. So the duration of treatment will depend on symptom severity and individual needs, the risk profile should be reassessed with your doctor every year.

Can Natural Alternatives Be Used Instead Of HRT?

Over-the-counter supplements and herbal tablets can relieve some of the symptoms. However, studies failed to show significant benefits of these for hot flashes. Also, herbal treatments do not prevent bone loss or protect against heart disease. Moreover, unproven treatments can have their own side effects. Therefore, before starting herbal treatments, it will be in your best interest to consult your doctor.

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