Hormone replacement therapy FAQs

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For decades, doctors have recommended hormone replacement therapy for the treatment of menopausal symptoms. This treatment has also been useful in reducing the risk of heart disease and osteoporosis, as well as having other benefits. However, many studies have been launched to establish whether hormone replacement therapy is a safe treatment option method, and due to speculations about its risks, it is necessary first to understand everything about hormone replacement therapy.

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When is hormone replacement therapy recommended as treatment?

At the onset of menopause, the levels of natural oestrogen and progesterone drop. This is followed by several conditions like the development of hot flashes, vaginal dryness as well as painful intercourse. Many women also face changes in their moods and experience sleep problems. With such conditions beckoning, it becomes necessary to embrace preventive measures, which can help one to lead a normal life.

Hormone replacement, therefore, serves the role of replacing those hormones that are lost at the onset of menopause, thereby allowing one to lead a normal life. This treatment catalyses calcium production, which in turn helps in maintaining the right levels of cholesterol. The availability of oestrogen keeps the vagina healthy, so embracing hormone replacement allows one to remain healthy and comfortable during intercourse. HRT is not only useful to those who have reached menopause, but also some women who have hormone imbalances, leading to the symptoms mentioned above and conditions.

How does hormone replacement therapy work?

The mechanism behind hormone replacement therapy is simple: it assumes the roles of oestrogen and progesterone to restore the body to its normal functions. Naturally, oestrogen released by the body helps in the development and release of eggs from the ovary and helps in the regulation of monthly periods. Oestrogen is also responsible for keeping the vagina moist, and lack of the hormone usually leads to dryness and pain during intercourse.

HRT restores the functions of the body that are affected due to a decline in natural oestrogen in the body. This is simply a re-introduction of the hormone to save the patient from conditions like vaginal dryness and night sweats.

On the other hand, natural progesterone prepares the womb for pregnancy and offers protection to the lining (endometrium). When used together with oestrogen, progesterone will work to keep the body in stable condition when menopause kicks in. It helps to trigger the chemical reaction that prevents the symptoms and conditions that arise due to menopause.

What hormone replacement therapy treatment should I use?

Oestrogen only therapy. For women who face symptoms like hot flushes, vaginal dryness and loss of libido at the onset of menopause, oestrogen-only therapy may be considered. This depends on several factors like whether your body is in the right state to respond to that single treatment, or whether a combination will be needed to settle the problem. Those facing vaginal dryness can opt for vaginal oestrogen treatment. Likewise, young women who undergo ovary and uterus removal should take additional testosterone therapy.

The combined hormone replacement therapy. If you want to protect the endometrium during treatment, you should opt for a combination of oestrogen and progestogen, which is a mild treatment option. If taken alone, oestrogen increases the chances of developing endometrium cancer, so during treatment, it is recommended to use a combination.

How do you use hormone replacement therapy?

Hormone replacement therapy can be administered in different ways, depending on the diagnosis. Different patients respond in unique ways to this treatment, so it is vital to choose what works best for each patient. The therapy can be administered either as tablets, gels as well as skin patches. Each product comes with different kinds of oestrogen, which share the same role in treating menopausal symptoms. There is no rule to which method is perfect, but many professionals cite patches and gels as the best choice for patients with a high concentration of triglyceride.

There are different vaginal oestrogen creams, which are perfect for women who show symptomatic dryness of the vagina. The reason tablets are not a common recommendation is because patients with conditions like hypertension and overweight may show slow responsiveness to absorption.

What are the benefits of using hormone replacement therapy?

Oestrogen used in hormone replacement therapy reduces the severity of hot flushes by more than 85 per cent. It helps to ensure levels of discomfort brought by hot flushes are reduced or eliminated. Additionally, if you are suffering from vaginal dryness, hormone replacement therapy could come in handy to solve the problem through the administration of oestrogen, which helps to offer a solution. Hormone replacement therapy also helps to improve one’s lifestyle by eliminating or reducing menopausal symptoms, which include poor sleep quality and pain.

Post-menopausal bone fractures are also common in many women who go through this stage of life. One of the most common conditions in this category is hip fracture, which is a painful occurrence. Usually, oestrogen catalyses the production of calcium, which is necessary for the strengthening of bones. Therefore, opting for hormone replacement therapy will prevent the occurrence of painful conditions like post-menopausal fractures.

Do I still need to use contraception while taking HRT medications?

Although it is less likely to get pregnant around menopause, it is vital to keep using contraception. There are many contraceptive options available in the market, but the main question women ask is whether hormone replacement therapy can take the place of contraceptives. Hormone replacement therapy does not contain the right levels of hormones, so this cannot be used as a contraceptive. Unless you have finished menopause and have reach the post-menopausal stage, you should still consider using contraception until about 55 years depending on how your body responds. If you have had surgical removal of the uterus and/or ovaries, you will not need to use contraception to prevent pregnancy, but it can still protect you from STIs.

Are there any dangers associated with hormone replacement therapy?

Hormone replacement therapy should only be issued to offer relief of menopausal symptoms, and women are advised to take this medication until menopause is over. Professional review is needed after 50 years to ascertain whether it is still necessary to continue with treatment. As much as hormone replacement therapy comes with benefits to the user, there are also risks associated with the treatment.

Long term use of hormone treatment therapy increases the chances of getting breast cancer. Taking combined hormone replacement therapy increases mammographic density, one of the risk factors for breast cancer. In other cases, patients suffered blood clots (venous thromboembolism), which is a risk that increases with age while using hormone replacement therapy. Taking oral hormone replacement therapy increases the risk of stroke and gall bladder inflammation, especially in women younger than 60 years.

Can hormone replacement therapy cause cancer?

While hormone replacement therapy may not be ominous as it was in 2002, there are no clear links to breast cancer. Many experts argue that following the announcement made by WHI regarding health risks of the treatment, many users stopped using this method en mass. There was a decline in breast cancer incidences following this reaction, something that offered conviction that there could be links between hormone replacement and the development of cancer. The duration one uses these hormones matters and is the sole reason behind the occurrence of breast cancer. Women who remain in the therapy longer stand higher risks of getting cancer during or after the duration.

A more prolonged exposure to combined hormone replacement therapy could increase the risk of breast cancer. Oestrogen alone has not shown any effects as regards to causing cancer, but there are cases where patients experienced a change in the density of their breasts. This is said to make it more challenging to make a successful diagnosis of cancer, and in the event it hits, the patient realises when it is too late.

How long can you be on hormone replacement therapy?

On average, menopause begins at the age of 51. Every person responds differently to this change, so there is no standard measure that can be used to assess how long it should last. The duration of symptoms could also vary, so the length of time taken while on hormone replacement therapy could also differ from one person to another. According to doctors, low-dose treatment is an effective way to work with hormone replacement therapy, and it helps to limit the possible increased risk of breast cancer and heart disease. Therefore, using hormone replacement therapy for about five years is reasonable and safe.

Are there any circumstances when hormone replacement therapy should be stopped?

Most women stop taking hormone replacement therapy after their menopausal symptoms stop, which usually happens after two to five years from the onset of menopause. Lowering the dose gradually is the best way to withdraw usage, and it helps one to avoid having a relapse of symptoms. It is usually advisable to keep in contact with your GP to know how you should withdraw usage because doing so suddenly could lead to other complications. Also, take note of the pattern of symptoms to note whether there is an improvement. In case something different than the usual feeling is noted, you should not hesitate to visit a health professional for checkups.

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