Womens Health Blog

Hormone replacement therapy is the term used for supplementation of female sex hormones, especially estrogen, after menopause. The main aim of hormone replacement therapy is to reduce the risk of heart diseases and osteoporosis after menopause and to provide relief from troublesome symptoms of menopause.

Estrogen can be supplemented either daily or in cycles where a few days break is given every month. Progesterone is also added with estrogen in women who have not had hysterectomy. This is to prevent changes in the structure and functions of the inner lining of the uterus. Progesterone supplemen­tation is normally given for ten to fourteen days, depending upon its type. At the end of progesterone supplementation, you will have bleeding, which will be similar to normal menstruation.

Estrogen can be supplemented in three ways:

1. Orally, as tablets;
2. Below the skin, as implants, and
3. Through the skin such as in gel or patch forms.

All the above three ways of estrogen supplementation are effective in management of troublesome symptoms of meno­pause and protection against bone loss and heart diseases.
In case you have mild symptoms of the urinary system or external genital organs (such as itching, etc.), your doctor is likely to recommend a milder type of estrogen that can be used continuously. You can take it either as tablets or as vaginal cream.

The decisions on when to start hormone replacement therapy and how long to continue it will depend mainly upon your symptoms and assessment of the benefits versus risks of the therapy. The benefits of hormone replacement can start within a few weeks and normally continue as long as you take the replacement. The symptoms can recur when you stop the therapy. This is why most doctors recommend long-term hormone replacement therapy.

Benefits of hormone replacement therapy

Hormone replacement therapy almost always controls hot flushes at night. It also reverses the changes in the structure of the inner lining of the vagina and urinary tract and makes them thick, stimulates vaginal glands to secrete fluids that act as lubrication during sexual intercourse. This is why it can also enhance sexual desire.
Hormone replacement therapy is effective in reducing the risks of heart attack and osteoporosis.

Some women report that estrogen helps control their irritability and mood changes. Some studies have indicated that estrogen enhances the effects of medicines used to treat depression.

As age advances, oil production in the glands of the skin reduces. As a result, the skin becomes dry and wrinkled. It is believed that estrogen therapy helps regulate activity of the oil glands in the skin and therefore makes it look younger. It is important to remember that while hormone replacement therapy may improve the skin and hair texture, it is not recommended for this benefit alone.

Risks of hormone replacement therapy

Some studies have indicated that hormone replacement after menopause may increase the risk of breast cancer. However, some other studies have indicated otherwise. They have indicated that the risk of cancer reduces after eight to ten years of estrogen replacement. Since it is not conclusively proven if hormone replacement increases the risk of breast cancer, your doctor will weigh the benefits of protection against heart diseases and osteoporosis with the risk of breast cancer before recommending if you need hormone replacement or not.

Estrogen replacement can increase the risk of blood clots in the veins and are therefore not recommended if you have the tendency to develop blood clots in the leg veins.
Some studies have indicated that higher doses of estrogen can worsen high blood pressure. Your doctor will therefore assess the risk of heart attack and then recommend estrogen dose most suited to you.

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