Hormone Replacement Therapy (HRT) FAQ
What is Hormone Replacement Therapy (HRT)?
Hormone Replacement Therapy, is supplementing women with one or more of the hormones oestrogen, progesterone and testosterone, that are lost during the menopausal transition. These are hormones already made by your body in your ovaries.
HRT is recommended by national guidelines as the first choice for women who have symptoms caused by low or fluctuating hormone levels. It has been shown to offer the most effective relief from symptoms, and for the majority of women the benefits of taking HRT outweigh the risks.
Who can benefit from Hormone Replacement Therapy?
Women may chose to take HRT for two reasons.
By replenishing your hormone supply, HRT reduces your menopausal symptoms such as hot flushes, night sweats, mood swings, fatigue, decreased libido, vaginal dryness, reduced muscle mass, brain fog and many more.
But oestrogen and sometimes testosterone can also protect you from chronic diseases such as osteoporosis, heart disease, stroke, dementia and mood changes. Those who have an early menopause are particularly at risk and should take it until they are at least 50 years old.
For best results, hormone therapy should be tailored to each person and reevaluated every so often to be sure the benefits still outweigh the risks.
What are the different methods of administering Hormone Replacement Therapy?
Are there any risks or side effects associated with Hormone Replacement Therapy?
While HRT is generally safe and effective, there are minor risks to consider:
Breast Cancer: Combined HRT (oestrogen and progestogen) can slightly increase the risk of breast cancer, particularly with extended use. The risk diminishes after stopping HRT and is lower when using micronised progesterone. However, it’s essential to consider this risk in the context of individual factors, such as obesity and moderate alcohol consumption – both which increase the risk.
Blood Clots: In rare cases, women with a history of blood clots, liver disease, or migraines may face a small risk of clot formation with oral oestrogen. However, this risk doesn’t apply when taken through the skin in patches, gels, or sprays, making these methods safer for these women./div>
When should you begin HRT?
It is best to start taking HRT when you start to experience symptoms that have any negative impact on your quality of life. For many women, these symptoms emerge during perimenopause, the period leading up to menopause. You do not need to wait until your periods have stopped to start taking HRT. HRT is recommended as first line treatment for managing the symptoms, and for the majority of women who start HRT below the age of 60, the benefits of taking HRT outweigh the risks.
While the most significant long-term health benefits are observed in women who commence HRT within ten years of menopause, HRT can be initiated at any age. There is limited research on the advantages of starting HRT in older women, as this area has not been extensively studied. Nonetheless, most healthy women can still derive benefits from HRT, even if it has been more than a decade since their menopause. This decision should be made on an individual basis.
How long does Hormone Replacement Therapy typically last?
According to guidance from the British Menopause Society, there is no strict limit to the duration of HRT use. If you continue to be healthy and feel the benefits of taking HRT, there is no reason for stopping it. The decision to continue treatment should be based on your specific circumstances. The dosage, treatment plan, and duration of HRT should be tailored to your individual needs, with an annual assessment of the advantages and disadvantages of ongoing HRT use. Smaller doses of oestrogen are often needed in older women and there are preparations of lower doses specifically for older women.
The safest way to take replacement oestrogen is through the skin in a patch, gel or spray. It has been shown that even a small amount of oestrogen replacement can often alleviate your symptoms effectively and provide you with the bone and heart protection you need. If you still have your womb (uterus) you will also need to take a progestogen, such as micronised progesterone, to protect the lining of your womb.
Is Hormone Replacement Therapy suitable for everyone?
The suitability of taking HRT depends on your age, your menopause symptoms and any risk factors you have. If you’re under the age of 60, experiencing menopause symptoms, and are not at high risk of breast cancer or blood clots the benefits of HRT are likely to outweigh the risks. However, HRT may not be the best option, or a specialist opinion may be needed, if you: have a history of breast cancer, ovarian cancer or uterine (womb) cancer.
Additionally, the risks and benefits of HRT should be carefully evaluated for each individual based on their medical history, age, lifestyle factors, and treatment goals.
How can I get started with Hormone Replacement Therapy?
If you are experiencing symptoms of hormonal imbalances and are considering Hormone Replacement Therapy, it is essential to consult with a qualified healthcare provider specialising in hormone health. They can evaluate your symptoms, perform necessary tests, and recommend a personalised treatment plan tailored to your individual needs and goals.
Contact Our Menopause Clinic
For more information on the treatment options available and to schedule a consultation, please contact our Menopause Clinic.
Our dedicated team of specialists is here to provide you with the support and guidance you need during this transformative phase of life.
some common misconceptions about Hormone Replacement Therapy (HRT)
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HRT is Only for Menopausal Women
While HRT is commonly associated with menopausal women, it can also benefit men and women experiencing hormonal imbalances due to conditions such as andropause, hypogonadism, or certain medical treatments.
HRT Causes Weight Gain
There is a misconception that HRT inevitably leads to weight gain. While some individuals may experience temporary weight fluctuations or water retention when starting HRT, proper dosage and management can minimise these effects. In fact, HRT can help maintain muscle mass and metabolic function, which may aid in weight management.
HRT Causes Breast Cancer
Concerns about the link between HRT and breast cancer have led to misconceptions about its safety. While some studies have suggested a slight increase in breast cancer risk with long-term use of certain types of HRT, the overall risk is low, and the benefits may outweigh the risks for many women. It’s essential to discuss individual risk factors with a healthcare provider.
HRT is Only for Severe Symptoms
Some people believe that HRT is only necessary for individuals experiencing severe menopausal symptoms. However, HRT can be beneficial for managing a range of symptoms, including mild to moderate hot flushes, night sweats, mood swings, and vaginal dryness, improving overall quality of life. Plus HRT improves our risk of developing long term health conditions such as osteoporosis and heart disease.
HRT is the Same for Everyone
There is no one-size-fits-all approach to HRT. Each individual’s hormone levels, symptoms, medical history, and treatment goals are unique, requiring personalised evaluation and treatment planning. HRT should be tailored to meet the specific needs of each patient.
HRT is Always Necessary for Menopause
While HRT can be effective in managing symptoms and reducing long term health risks, it may not be the best option for everyone. Lifestyle modifications, dietary changes, stress management techniques, and alternative therapies may also help alleviate symptoms and help prevent long term health conditions. Women should be making these lifestyle choices regardless of starting HRT or not.
HRT is Addictive
HRT is not addictive in the same way that certain drugs or substances can be. However, abruptly stopping HRT without proper medical supervision can lead to a return of menopausal symptoms. It’s essential to work closely with a healthcare provider to taper off HRT gradually if discontinuation is desired.
HRT Always Increases Libido
While HRT can improve libido and sexual function for some individuals by addressing hormonal imbalances, it is not a guaranteed solution for all sexual health concerns. Other factors such as relationship issues, stress, fatigue, and psychological factors may also contribute to changes in libido.
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DR ANGELA RAI
DR NATALIA BOGATCHEVA
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