What is hormone replacement therapy (HRT)?
Hormone replacement therapy (HRT) is a treatment for women who have reached or passed menopause, which often is referred to as "the change of life." HRT involves taking small doses of one or two female hormones, estrogen and progesterone.
Before menopause, the female body produces the hormones estrogen and progesterone in the ovaries. Estrogen works to regulate a woman’s monthly menstrual cycle and secondary sexual characteristics (such as breast development and function), and also prepares the body for fertilization and reproduction. Progesterone is released each month during menstruation to prepare the uterus for possible pregnancy and to prepare the breasts for lactation (milk production). As a woman reaches menopause, typically around 50 years old, her body produces less and less estrogen and progesterone.
Hormone replacement therapy (HRT) is synthetic estrogen and progesterone (called progestin) designed to "replace" a woman's depleting hormone levels. Decreased levels of estrogen may cause hot flashes, vaginal dryness, sleep disturbances, or other bothersome side effects. The dryness of tissue surrounding the vagina and urethra may cause pain during sexual intercourse or urination. HRT help to relieve these and other menopausal symptoms. Past research has shown that HRT may also help prevent osteoporosis, heart disease, short-term memory loss, depression and other diseases in post-menopausal women. (However, recent research has found that HRT may not provide these benefits and may pose other risks-see sections below for more information).
Hormone replacement therapy (HRT) provides women with, or replaces, hormones that their ovaries stop making. The ovaries make estrogen and progesterone as part of the menstrual cycle. The ovaries also make androgens, including testosterone. Hormone levels usually start to change during perimenopause, the years just before menopause. In perimenopause, many women begin to have symptoms such as hot flashes, vaginal dryness, irregular periods, and insomnia. The reason for the symptoms is usually fluctuating and declining hormone levels.
These hormonal changes are due to aging ovaries that are losing their ability to produce eggs and hormones. Women may have widely varying estrogen levels during their monthly cycles as the ovaries keep trying to produce eggs. Often there will be cycles in which no ovulation occurs (called anovulatory cycles) and no progesterone is produced. This can lead to irregular cycles with heavy or abnormal bleeding as a woman approaches menopause. At menopause, the ovaries stop producing and releasing eggs (ovulating) each month, and monthly periods stop completely. The ovaries are no longer producing estradiol and progesterone (although they continue to produce androgens). Menopause does not mean, however, that you have no estrogen in your body anymore. Women with more body fat usually have more estrogen than thinner women do, because estrogen is aromatized in fatty tissue. After menopause, there is much less estrogen and testosterone in the body than before menopause, and very little progesterone. This drop in hormone levels can have various effects, including the familiar symptoms of menopause such as hot flashes, night sweats, vaginal dryness, and loss of libido.
A woman who has a surgical menopause, in which her ovaries are removed (usually along with her uterus and fallopian tubes), will have a much more sudden drop in all sex hormone levels than a woman going through natural menopause. This sudden loss of hormones can cause severe symptoms and health problems, especially in younger women, unless adequate hormone replacement is provided.
HRT is most often prescribed to help with the symptoms of menopause. HRT may have a number of other benefits, such as preventing bone loss, but it also has risks. Talk to your healthcare provider about all possible options. Depending on your situation, you may decide to use HRT on a short-term basis, a longer-term basis, or not at all.
More information on menopause
What is menopause? - Menopause is a stage of the human female reproductive cycle that occurs as the ovaries stop producing estrogen, causing the reproductive system to gradually shut down.
When does menopause occur? - Most premenopausal women experience changes in their menstrual cycle. Perimenopause is the phase before menopause actually takes place, when ovarian hormone production is declining and fluctuating, causing a host of symptoms.
What are the signs and symptoms of menopause? - The symptoms of menopause can be divided into early and late onset symptoms. Early symptoms include abnormal vaginal bleeding, hot flashes, and mood changes. Late symptoms include vaginal dryness and irritation, osteoporosis, and heart disease.
What causes menopause? - Menopause occurs when the ovaries are totally depleted of eggs and no amount of stimulation from the regulating hormones can force them to work.
What is premature menopause? - Premature menopause is menopause that happens before the age of 40 - whether it is natural or induced.
What is perimenopause? - Perimenopause is the stage of a woman's life before menopause. The perimenopause is a normal period of transition between the childbearing years and menopause.
What is postmenopause? - Postmenopause is the time when most of the transitional stress of menopause has passed. Since postmenopausal women produce less estrogen, there are some symptoms that they might experience.
What are the treatment options for menopause? - Treatments for menopause can be divided based on those symptoms that are present in a given woman at a specific time. The standard of treatment for menopausal symptoms is replacement of one or both of the major female hormones.
What is hormone replacement therapy (HRT)? - Hormone replacement therapy (HRT) is a treatment for women who have reached or passed menopause, which often is referred to as "the change of life."
What are the benefits of hormone replacement therapy? - The benefits of hormone replacement therapy include controlling menopause symptoms, preventing heart disease, preventing osteoporosis, preventing some hard-to-detect female cancers.
What are the risk factors for hormone replacement therapy? - Hormone replacement therapy (HRT) risks and possible side effects include increased risk of cancers, blood clots, gallbladder disease, and heart attack or stroke.
What hormones are used in hormone replacement therapy? - The menopause is associated with a relative lack of oestrogens and progestogens. Replacement therapy always requires oestrogens, which are given continuously.
How is hormone replacement therapy taken? - There are many ways of taking HRT, including a daily tablet, skin patches, a small pellet or implant under the skin, a gel applied daily to the skin, or a nasal spray.
What is natural hormone replacement therapy? - Natural hormone replacement therapy (NHRT) is a combination of human estrogens and natural human progesterone.
What are herbal remedies for menopause? - Some women take herbal, natural, or plant-based products to help their symptoms. Wort and chasteberry may help some women with depressed mood.
What is estrogen replacement therapy (ERT)? - Estrogen Replacement Therapy (ERT) is therapy to replace estrogen no longer made by a woman's body because she is post-menopausal or her ovaries have been damaged or removed.
What menopause diet is suggested? - Eating right can definitely ease the various discomforts of menopause including hot flashes, bloating and mood swings.