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With over 40 million women in the US over the age of 50, hormone replacement therapy is widely used and continually growing.
Hormone replacement therapy made its debut in the 1940s, though it wasn't widely used until the 1960s. Since then, it has been used as a way to regulate some of the more troublesome side effects of menopause.
There are 34 symptoms of menopause, and hormone replacement therapy helps mitigate them.
Some of the more annoying side effects of menopause include hot flashes, vaginal dryness, osteoporosis, difficulty concentrating, fatigue, loss of libido, panic disorder, frequent urinary tract infections, mood swings, irregular periods and more.
Read on to learn more about the benefits of HRT, or hormone replacement therapy.
Types of Hormone Replacement Therapy
Women can take a few types of hormone replacement therapy. One of the most advanced types is the Bioidentical Hormone Replacement Therapy (BHRT).
Doctors tailor BHRT to each individual woman by using their saliva samples. These hormones replicate the types of hormones women who are not menopausal create. However, with BHRT, the synthesized hormones may not be at the same level in the patients' blood. Therefore, it might not treat all of the symptoms.
Women can also take systemic hormone replacement therapy, which treats all of the side effects of menopause. These therapies are that which really help with hot flashes and night sweats, two of the most brutal menopause side effects.
Low-dose vaginal treatments are also available. Placed locally within the vagina, they can help with issues such as UTIs, vaginal dryness and discomfort during sex.
What Are Available Forms of HRT?
Hormone replacement therapies come in a variety of forms, and systemic HRTs can offer varying amounts and types of hormones.
Typically, HRTs come in vaginal rings, patches, creams or are taken as a pill each day, almost like traditional birth control.
The doctor will prescribe HRTs based on what the individual woman needs.
Women who have had their ovaries or uterus removed will not need a pill that contains progesterone. Therefore, they will utilize estrogen-only hormone replacement therapy.
Some women use a cyclical or sequential HRT, which is, essence, taken like a birth control pill. This pill does not protect against unwanted pregnancies, but it does help mitigate the side effects of menopause.
Cyclical HRTs are for women who are still menstruating but are just beginning to have perimenopausal symptoms. The types of hormones a woman will take and when will depend on what their doctor prescribes. Generally, the woman will take both estrogen and progesterone, though the timing will differ from woman to woman.
Women who have already been through menopause but still have their womb or ovaries will take continuous HRTs. These are a combination of estrogen and progesterone.
Although it is becoming less common, some women will take a long-cycle HRT, which causes her to have what is known as withdrawal bleeds every three months.
Others will take localized estrogen. As mentioned previously, this is typically inserted into the vagina via a pill, ring, cream or gel. This provides relief for some of the issues associated.
When Do Patients Stop Taking HRT?
As soon as the doctor decides it is no longer necessary to take HRT, the patient will gradually withdraw and cease her usage.
Benefits of HRT
The usage of HRTs was called into question in 2002 and 2003 after a study by the Women's Health Initiative (WHI) which linked HRTs to endometrial and breast cancer.
However, these findings have since been called into question themselves, and findings state that the combination progesterone, estrogen pill only caused an extra case of breast cancer per every 1,000 women.
In 2012, the BMJ stated that usage of these pills may or may not cause a risk of breast cancer.
There are some well-documented benefits of taking hormone replacement therapy.
Firstly, HRTs can improve your muscle function, which decreases as you age.
They can reduce your risk of heart failure and heart attack, two thinks elderly people of both sexes are at a greater risk of developing.
HRTs can also help curb the aging process in women. Aging will still occur, but it can have long-lasting and better effects on the skin, especially in younger women who start them as soon as they begin to have menopausal symptoms.
Generally, HRTs help with relieving some of the most unpleasant symptoms of menopause. This is especially the case for women who undergo early menopause, or who experience it before the age of 45.
HRTs can also help increase your lost sex drive, protect against uterine cancer, reduces hot flashes and help reduces urinary and incontinence issues.
The most beneficial aspect of HRTs is that they can prevent and help treat osteoporosis. Osteoporosis is when bones become brittle as the individual ages, making them more prone to breaks and hairline fractures.
Preventing and Treating Osteoporosis
Over time, if not treated, osteoporosis can cause the loss of height, a collapsed spine, breaks that take longer to heal, stooped posture or back pain. If the illness becomes extremely active, individuals can have small breaks or hairline fractures they don't even notice. Over time, this can result in disability or the loss of mobility.
Those who have osteoporosis are at an increased risk of mortality in the first five years after a major fall or break. Fractures may also cause permanent disability.
Women, especially those who have smaller frames, are at a higher risk for the disease. Those who went through menopause early are especially at a higher risk for developing it, which is why these women should see their doctor for HRTs as soon as possible.
In addition to taking HRTs to help prevent and treat osteoporosis, women, especially those over the age of 50, should ensure they are getting enough calcium. They should also do weight-bearing activities and cut down on their alcohol intake.
Taking HRTs can help correct some of the problems associated with osteoporosis, but it won't prevent it completely. Before menopause, women should eat a healthy diet and exercise as much as possible. A sedentary lifestyle is one of the major risk factors for developing osteoporosis.
Are There Side Effects to Taking Hormone Replacement Therapy?
We have already discussed the ways in which hormone replacement therapy can help improve function and relieve menopausal symptoms. But like everything you place in your body, there are a few risks and side effects associated with it that you should definitely be mindful of. Before taking any kind of medication or HRT, you should discuss the benefits and risks of it with your doctor to ensure you're doing more good than harm to your body.
Some women who take HRTs experience headaches. This can be uncomfortable, but for many women, this is not enough to get them to stop taking HRTs altogether.
Women who have circulatory issues or who have a history of blood clots and strokes will likely be advised not to take HRTs. This is because taking hormones can cause an increased risk of an embolism and blood clot, and already being prone to one makes it much more likely. Women who already have illnesses that can cause "sticky blood" are also not advised to take HRTs.
Your breasts may become more tender as you take the hormones, just as they do during your period or pregnancy. In some cases, this can make your breasts denser during a mammogram and can make breast cancer more difficult to spot.
Some women also experience nausea or bloating when they take hormone replacement therapies. They may also experience fluid retention and can cause a higher risk of gallstones or gallbladder issues amongst women who still have their gallbladder.
There is still no evidence one way or the other to determine HRTs' effects on dementia. Scientists believe that in some cases, hormone replacement therapies can cause dementia and Alzheimer's, whilst others say the link is not clear. Some studies have even linked the use of HRT to a lower risk of Alzheimer's and dementia, saying women who use the pills have a much lower chance of developing this orders.
Some women also experience slight skin irritation with the use of HRTs. The irritation is most commonly associated with putting creams, gels or patches directly on your skin. If this happens to you, you can discuss alternatives with your doctor.
The Basics of Hormone Replacement Therapies
Hormone replacement therapies are on the whole, a good option for women experiencing menopause. It can help manage symptoms and make the transition much easier. Most women do not stay on HRTs for an indefinite period and can try a variety of options if needed. For most women, the benefit of HRT outweighs the risk.
HRTs may not be for everyone, though, and women who have suffered from particular diseases or illnesses will not be good candidates for hormone replacement therapy.
Women should begin HRTs around the time they start menopause to minimize risks.
Read our blog for more information on menopause and bioidentical hormone replacement therapy.
Published: August 14, 2018
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