Though there are many hormones that the body makes, hormone replacement therapy or HRT typically refers to two major hormones made by the ovaries, which are estrogen and progesterone.
Types of hormone replacement therapy
When replacing estrogen in a woman who has a uterus, it is also necessary for progesterone or some sort of alternative that acts like progesterone to be administered. This is because progesterone protects the lining of the uterus from a build-up that estrogen causes. For women who have had a hysterectomy, only estrogen is needed and not progesterone, since there is no uterus present to protect the lining. However, with every form of treatment comes risks.
Risks of hormone replacement therapy
Risks of hormone replacement therapy may vary depending on whether estrogen is given alone or with progesterone. Other factors are considered as well such as the current age of the patient, age at menopause, the dose and type of estrogen and other health risks such as risk of heart disease, cancer risks and family medical history.
When to consider therapy
A woman should consider hormone replacement therapy if she experiences moderate to severe hot flashes, extreme sleep pattern changes, has lost bone mass and can’t benefit from other treatments. A woman can also consider such therapy if she has stopped having menstrual periods before age 40 or has lost the normal function of the ovaries before age 40. If a woman has experienced early menopause, particularly a woman who has had her ovaries removed and doesn't use estrogen therapy until the age of 45, she will have a higher risk of osteoporosis, coronary heart disease, Parkinson's-like symptoms, an increase in anxiety, depression, and even earlier mortality. Those who have a current or past history of breast cancer, ovarian cancer, endometrial cancer, or are prone to blood clots or stroke should usually not take hormone therapy.
Best practices for women taking hormone replacements
Women taking hormone replacements should not smoke, as smoking increases the risks by two to four times. If a patient and her physician decide that hormone replacement therapy is the right decision, some best practices to follow include:
- Find the best product and delivery method that works most effectively for that particular individual
- Minimize the amount of medication needed, because generally a lower dose for a shorter amount of time can be just as effective when taking estrogen
- Seek regular follow-up care to make sure everything is still on track
- Make healthy lifestyle choices such as exercising, eating a healthy diet, maintaining healthy weight, not smoking, limiting alcohol, managing stress effectively and managing chronic health conditions like high cholesterol or high blood pressure
Always consult with your doctor while taking any type of hormone replacement therapy, and pay close attention to potential side effects and risks.