HRT For Women

At menopause, a woman's body makes less estrogen. The menstrual cycle falters, becomes irregular, and stops. The lack of estrogen may result in symptoms such as hot flushes and vaginal dryness. There is also an increased risk of osteoporosis.

A woman may choose to take hormone replacement therapy (HRT) to restore estrogen after menopause. HRT is most often used to treat symptoms of menopause such as "hot flashes," vaginal dryness, mood swings, sleep disorders, and decreased sexual desire. This medication may be taken in the form of a pill, a patch, or vaginal cream.

The decision is made in consultation with a doctor, and is based on weighing the risks and potential benefits in light of the patient's:
1. Personal needs
2. Medical and family medical history
3. Existing symptoms
4. Risk of osteoporosis (see navigation menu at left for Major's osteoporosis page)

SUMMARY OF RISKS AND BENEFITS
As with all medication, there are side effects associated with HRT.
A patient may experience water retention, bloating, nausea, breast soreness, mood swings, and headaches. Side effects may be reduced or eliminated by changing the amount of the hormone or the way in which it is taken.

HRT is available in various forms, including pills, patches, and vaginal creams.

Some studies show increases in the risk of heart disease, breast cancer, blood clots, and stroke for a woman on HRT.

Each patient and her doctor must discuss and decide whether these risks outweigh the osteoporosis-preventing effect of HRT and the benefits of reducing the unpleasant symptoms of menopause.
Some women may wish to undertake a short-term treatment to get through the most disruptive stage of their menopause.

FORMS OF HRT
Your doctor will start you on a treatment that seems likely to be best suited to you. Every woman is different. You may have to try more than one regimen before finding what's best for you. Only women with intact uteruses require cyclic or combined therapy.

Cyclic hormone therapy is common. Here, estrogen is taken for 25 days, with progestin added somewhere between days 10-14. The two hormones are then taken together for the rest of the 25 day cycle. Then, no hormones are taken for 3-5 days. There is usually monthly bleeding with cyclic therapy. Pills or patches are available.

Continuous, combined therapy is where estrogen and progestin are taken together every day. When this therapy is started, or when a patient switches from cyclic to continuous, she may experience irregular bleeding. Most women stop the monthly bleeding within a year after starting continuous combined HRT.

Estrogen HRT is also available as a patch, allowing the hormone to be absorbed through the skin. Patients who have difficulty swallowing or remembering to take pills may particularly prefer this method. Delivery of the hormone by patch means the liver is not as involved, which may significantly reduce side effects and complications in some patients.

An estrogen cream may be the preferred treatment for vaginal dryness. Because an estrogen cream may not alleviate other symptoms of menopause, and does not appear to protect against bone disease, it is generally given in addition to one of the other forms.

Supplemental drugs may be recommended for some women with severe symptoms from menopause, or women who are at very high risk for osteoporosis or heart disease. One of these additional treatments might be the male hormone androgen, which can help to relieve severe hot flashes.

CAUTION: If you are a breast cancer survivor, HRT may not be appropriate.


ALTERNATIVES TO HRT
Some of the more common alternatives to HRT used by women include dietary phytoestrogens (plant extracts which mimic human hormones), natural progesterone, wild yam cream, herbal medicines and various non-prescription supplements. Sample products...

Lifestyle changes including diet, exercise and stress-management techniques and strategies are also proven ameliorants to the symptoms of menopause.

You'll fInd an immense amount of information and opinion (some of it suspect) on the Internet. As always, it's the responsible adult's task to educate herself so as to be better able to work with her physician in the quest for wellness.

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