Hormone Replacement Therapy: A Comprehensive Guide developed for Women by a Woman.

Photo by Mārtiņš Zemlickis on Unsplash

I know you are looking for hormone replacement therapy, I also understand that you must be facing some issues with your physical or mental health and that is why you want to understand more how you can improve it.

But before talking about HRT, I would like to share a story with you.

This is a story about me and my friend who is in her early 40s now.

I am not that far either, with in few years I will be her age too. But right now when I go and see her on weekends. She is stressed and a bit depressed.

This is the person who used to be flawlessly beautiful and had all the success in her life. And just because of hormonal imbalance, she is now in stress and desperate to figure out a solution.

What are the signs that you need hormone replacement therapy?

OK, so why I am writing this blog post? I am writing it because I started feeling the pain of my friend. Every weekend we meet and she either complains about or showcase her pain in her expressions.

And that drives me crazy. We females already have so many problems in our life, so why this one is another pain point in our life.

I am going to change the name of my friend and call her Agness!

Agness started expressing that recently she is experiencing hot flashes.

Not just that but also night sweats while she is in deep sleep.

Initially we both thought that it’s just work stress or some kind of imbalance in her lifestyle. As recently she had to go to Japan for few months, so that might have changed the strict exercise regime she used to follow.

But soon she realised that she is receiving these Vaginal drynesses that is actually causing her discomfort during sex.

Obviously that effects her not just physically but mentally too.

And we can clearly see a pattern here, isn’t it?

But that scares me because I am also at the verge of hitting that age group. And I do not want to go through all these pains.

So I started digging more information about this topic.

After, doing months and months of research, I found out that there are not many reasons for this pain.

It is basically due to some fundamental changes we go through. A female body goes through different level of estogen hormonal changes during her life.

Just as you can see below in this picture.

And one of the primary reason, or I should say indicator, that your body is loosing estrogen is menopause.

So I started digging about it.

And found out that because of this estrogen deficiency many other factors Menopause begins.

Why does menopause happen?

When females age, naturally they go through this hormonal changes in their bodies. Menopause happens naturally because of aging.

When a female does not have menstrual bleeding for a whole year, you could say her menopause has begin. But you must remember females could have no menstrual bleeding for a year because of surgery or other medical conditions too. Few examples are:

1. Hormonal Birth Control
2. Radiation Therapy
3. Surgical removal of ovaries etc.

Once a female reach to her puberty, her reproductive cycle begins. And it keeps running until the time comes when it begins to slow down.

Your bodies make less of hormone called estrogen, that is an indication menopause is nearing.

Another example is your menstrual cycle (period) starts changing. You see irregularities in your cycle and slowly it will stop.

Not just your menstrual cycles but you will see other physical changes.

This is because your body starts slowly accepting these hormonal changes. There are 3 stages of menopause:

1. Perimenopause
2. Menopause
3. Postmenopause

During these stages you will see different kind of changes in your body.

What hormonal changes happen during menopause?

When a woman’s body stops producing high level hormones, she faces traditional changes in her body. The primary function of ovaries is to store and release eggs, they are basically the reproductive glands.

But other important function of ovaries is, they produce estrogen and progesterone.

Menopause is a natural process that happens when your body goes through some changes. Your ovaries, which are important for making babies, stop making as many hormones as they used to.

These hormones, called estrogen and progesterone, control your periods and have other effects on your body too. When you go through menopause, your ovaries stop releasing eggs and you will have your last period.

How do I know if I’m in menopause?

Reaching menopause is like finishing a long book that you’ve been reading for many years. You know that you’ve reached the end of the book when you’ve read the last chapter and there are no more pages to turn.

Similarly, you’ll know that you’ve reached menopause when you’ve gone 12 months in a row without having a menstrual period.

However, just because you’ve finished the book doesn’t mean that there can’t be some unexpected epilogue. If, after finishing the book, you suddenly find a new chapter, it could be a sign that something isn’t quite right.

Similarly, if you experience any type of vaginal bleeding after menopause, it’s important to contact your healthcare provider. This could be a sign of a more serious health issue that needs to be addressed.

So I put a guide together with sub topics which will cover everything related to HRT below so that all of your doubts can be cleared about it.

I. Introduction

1. What hormone replacement therapy (HRT) is and why it’s used?

Hormone replacement therapy (HRT) is a medical treatment that involves taking hormones (usually estrogen and/or progesterone) to replace the hormones that the body no longer produces after menopause.

It’s often used to relieve symptoms of menopause such as hot flashes, night sweats, and vaginal dryness, and can also help prevent osteoporosis.

An analogy to understand HRT could be like refilling the gas in a car.

The car needs gas to run, just like our body needs hormones to function properly. When the car runs out of gas, it can’t function properly and may even stop running altogether.

Similarly, when our body stops producing enough hormones after menopause, we may experience uncomfortable symptoms and even be at risk for certain health conditions.

Hormone replacement therapy can help refill the tank and provide the body with the hormones it needs to function properly and avoid these negative effects.

2. Why HRT has been a controversial topic in recent years?

Hormone replacement therapy (HRT) has been a controversial topic in recent years due to conflicting reports about its safety and effectiveness.

While early studies suggested that HRT could reduce the risk of heart disease, stroke, and osteoporosis, more recent studies have raised concerns about the risks of long-term use, including an increased risk of breast cancer, blood clots, and stroke.

One of the key studies that contributed to the controversy around HRT was the Women’s Health Initiative (WHI) study, which was published in 2002.

The study found that HRT increased the risk of breast cancer, stroke, and blood clots in postmenopausal women, and as a result, many women and healthcare providers became more cautious about using HRT.

However, subsequent studies have challenged some of the findings of the WHI study and have suggested that HRT may still have benefits for some women, particularly when used for short periods of time and at lower doses.

For example, a 2017 review of studies on HRT and heart disease found that HRT may reduce the risk of heart disease in younger women, but not in older women.

Overall, the controversy around HRT highlights the importance of individualised care and informed decision-making in healthcare.

Women who are considering HRT should discuss the potential benefits and risks with their healthcare provider and make a decision that is based on their individual needs and preferences.

II. Benefits of HRT

1. What are some of the potential benefits of HRT, such as relief from hot flashes, night sweats, and vaginal dryness?

Hormone replacement therapy (HRT) can provide several potential benefits for women experiencing symptoms of menopause. Here are a few examples:

1. Relief from hot flashes and night sweats: HRT can help regulate the body’s temperature control system, which can reduce the frequency and severity of hot flashes and night sweats. This can lead to improved sleep and a better overall quality of life.
2. Improvement in vaginal dryness and discomfort: HRT can increase the thickness and elasticity of the vaginal tissue, which can alleviate vaginal dryness, itching, and discomfort. This can make sexual activity more comfortable and enjoyable for women.
3. Protection against bone loss and fractures: HRT can help protect against bone loss and reduce the risk of fractures. Estrogen helps to maintain bone density, and when levels decline after menopause, women are at higher risk for osteoporosis.
4. Improvement in mood and cognition: Some women experience mood changes and cognitive symptoms such as difficulty concentrating or memory lapses during menopause. HRT can help alleviate these symptoms and improve overall mood and cognitive function.

It’s important to note that the potential benefits of HRT may vary depending on the individual woman’s health history and other factors. Women considering HRT should discuss the potential benefits and risks with their healthcare provider and make a decision that is based on their individual needs and preferences.

2. HRT can also help prevent bone loss and reduce the risk of certain conditions, such as colon cancer

In my opinion HRT can help prevent bone loss and reduce the risk of certain conditions by replenishing the levels of hormones in the body that decline during menopause.

You will say but how? well, let me share some examples:

1. Protection against bone loss and fractures: HRT can help protect against bone loss and reduce the risk of fractures. Estrogen helps to maintain bone density, and when levels decline after menopause, women are at higher risk for osteoporosis. By supplementing estrogen through HRT, women can help maintain their bone density and reduce their risk of fractures.
2. Reduction in the risk of colon cancer: Studies have suggested that HRT may reduce the risk of colon cancer. One study found that women who took HRT had a 40% lower risk of colon cancer compared to women who did not take HRT. The protective effect may be due to the fact that estrogen has a positive effect on the cells lining the colon.
3. Improvement in cardiovascular health: Some studies have suggested that HRT may have a protective effect on cardiovascular health. Estrogen can help improve blood flow and reduce inflammation, which may reduce the risk of heart disease and stroke.

It’s important to note that HRT may not be suitable for all women, and the potential benefits and risks may vary depending on the individual woman’s health history and other factors.

Women considering HRT should discuss the potential benefits and risks with their healthcare provider and make a decision that is based on their individual needs and preferences.

3. Hormone Replacement Therapy: Balancing Benefits and Risks

When considering hormone replacement therapy (HRT), it’s important to balance the potential benefits with the potential risks. Here are some tips on how to make an informed decision:

1. Understand your personal health history: The potential benefits and risks of HRT may vary depending on your individual health history. For example, women with a history of breast cancer or blood clots may not be good candidates for HRT. Make sure to discuss your personal health history with your healthcare provider before making a decision about HRT.
2. Consider the severity of your symptoms: If you are experiencing severe symptoms of menopause such as hot flashes, night sweats, or vaginal dryness, the potential benefits of HRT may outweigh the risks. However, if your symptoms are mild or manageable, HRT may not be necessary.
3. Weigh the potential benefits and risks: Some potential benefits of HRT include relief from hot flashes and night sweats, improvement in vaginal dryness and discomfort, and protection against bone loss and fractures. However, there are also potential risks associated with HRT, such as an increased risk of breast cancer, blood clots, and stroke. Make sure to discuss the potential benefits and risks with your healthcare provider and weigh them carefully before making a decision about HRT.
4. Consider non-hormonal alternatives: There are non-hormonal alternatives to HRT that may be effective in relieving symptoms of menopause. For example, lifestyle changes such as regular exercise and a healthy diet may help reduce the frequency and severity of hot flashes. Non-hormonal medications such as selective serotonin reuptake inhibitors (SSRIs) or gabapentin may also be effective in relieving symptoms.
5. Reevaluate your decision regularly: If you do decide to start HRT, it’s important to reevaluate your decision regularly with your healthcare provider. Your individual risks and benefits may change over time, and it’s important to stay informed and make adjustments to your treatment plan as needed.

III. Risks of HRT

Hormone replacement therapy (HRT) has been associated with some potential risks, let’s talk about them:

Increased risk of breast cancer:

HRT has been associated with a small but significant increase in the risk of breast cancer. The risk appears to be greater with combination therapy (estrogen and progestin) than with estrogen-only therapy.

Increased risk of stroke:

HRT has been associated with a small increase in the risk of stroke. The risk appears to be greater in women who start HRT later in life, and in women who use combination therapy (estrogen and progestin) rather than estrogen-only therapy.

Increased risk of blood clots:

HRT has been associated with an increased risk of blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE). The risk appears to be greater in women who use combination therapy (estrogen and progestin) rather than estrogen-only therapy.

Increased risk of gallbladder disease:

HRT has been associated with an increased risk of gallbladder disease, particularly in women who use combination therapy (estrogen and progestin) rather than estrogen-only therapy.

Other potential risks:

HRT has also been associated with an increased risk of other health conditions such as heart disease, dementia, and ovarian cancer, although the evidence is mixed and more research is needed to fully understand the potential risks.

It’s important to note that the risks associated with HRT may vary depending on the individual woman’s health history, age, and other factors. Women considering HRT should discuss the potential risks and benefits with their healthcare provider and make an informed decision based on their individual needs and preferences.

What are the Pros and Cons of Hormone Replacement Therapy?

So after reading this much you must be wondering. Well, Amy you done a lot of research. Can you please summaries what are the pros and cons.

So that I can literally evaluate my options. I am going to do exactly that here:

Pros:

1. Relieves symptoms of menopause: HRT can help alleviate many of the symptoms of menopause, such as hot flashes, vaginal dryness, and mood swings.
2. Reduces the risk of osteoporosis: HRT can help prevent bone loss, which can lead to osteoporosis.
3. Lowers the risk of colon cancer: HRT has been shown to reduce the risk of colon cancer.
4. Reduces the risk of heart disease: HRT may help reduce the risk of heart disease in some women.

Cons:

1. Increased risk of breast cancer: Some studies have suggested that HRT can increase the risk of breast cancer, especially when used for more than five years.
2. Increased risk of blood clots and stroke: HRT may increase the risk of blood clots and stroke, especially in women who smoke or have other risk factors.
3. Increased risk of endometrial cancer: Women who use estrogen-only HRT may be at increased risk of endometrial cancer.
4. Other side effects: HRT can cause other side effects, such as headaches, bloating, and nausea.

IV. Who Should Consider HRT?

Yes, several factors can influence whether HRT is a good option for someone. Here are some of the most important ones:

1. Age: Women who are younger than 60 or within 10 years of menopause onset may benefit from HRT the most. Women who start HRT after age 60 or more than 10 years after menopause onset may be at increased risk of certain health problems.
2. Severity of menopausal symptoms: HRT is most effective at relieving hot flashes, night sweats, and vaginal dryness. Women who have severe symptoms that affect their quality of life may benefit from HRT.
3. Health history: Women with a history of breast cancer, blood clots, stroke, or heart disease may not be good candidates for HRT. HRT may increase the risk of these health problems or interfere with their treatment.
4. Personal preferences: HRT is not the only treatment option for menopausal symptoms. Women who prefer non-hormonal treatments or who are concerned about the risks of HRT may choose alternative therapies.
5. Length of time since menopause: Women who have been in menopause for a long time may not benefit from HRT as much as women who have recently entered menopause.
6. Type of HRT: The type of HRT (estrogen-only or combination estrogen and progesterone) may be influenced by a woman’s health history, such as whether she has had

Remember it is important to note that the decision to use HRT should be made on an individual basis, taking into account a woman’s personal medical history, risk factors, and symptoms.

You should discuss the risks and benefits of HRT with you doctor before deciding whether to use it. So speak with your GP (doctor) and only then make a decision.

V. Types of HRT

Hormone replacement therapy (HRT) is a treatment used to alleviate the symptoms of menopause by replacing hormones that the body no longer produces in sufficient amounts. There are two main types of HRT:

Estrogen-only therapy:

This type of HRT contains only the hormone estrogen. It is typically prescribed for women who have had a hysterectomy (removal of the uterus) because they do not need the progestin component to protect against uterine cancer.

Estrogen-only therapy can help reduce hot flashes, night sweats, vaginal dryness, and other symptoms of menopause.

Combined estrogen and progestin therapy:

This type of HRT contains both estrogen and progestin, a synthetic form of progesterone.

It is typically prescribed for women who have not had a hysterectomy because estrogen alone can increase the risk of uterine cancer.

The progestin component helps to protect the uterus from the potential cancer-causing effects of estrogen. Combined estrogen and progestin therapy can also help reduce menopausal symptoms and may provide additional benefits, such as reducing the risk of osteoporosis.

However, it is important to note that this type of HRT has been associated with some health risks, such as an increased risk of breast cancer, blood clots, and stroke, and should be used with caution.

VI. How to Take HRT

• Explain the different ways that HRT can be taken, such as pills, patches, creams, and gels
• Mention that the choice may depend on personal preference and medical history

How much hormone replacement therapy cost?

To be honest I do not care which form the treatment comes to me when it is the matter of my health.

HRT can be taken in different forms, including pills, patches, creams, and gels. The method of delivery can vary based on the type of HRT prescribed, personal preference, and other factors.

1. Pills: HRT pills are the most common form of HRT and are taken orally. They are available in both estrogen-only and combined estrogen and progestin forms.
2. Patches: HRT patches are applied to the skin and release hormones into the bloodstream over time. They are available in both estrogen-only and combined estrogen and progestin forms.
3. Creams: HRT creams are applied topically to the skin and are absorbed into the body. They are available in both estrogen-only and combined estrogen and progestin forms.
4. Gels: HRT gels are also applied topically to the skin and absorbed into the body. They are available in both estrogen-only and combined estrogen and progestin forms.
5. Vaginal creams or tablets: These forms of HRT are specifically designed to treat vaginal dryness and related symptoms. They are typically estrogen-only and are applied directly to the vagina.
6. Injections and implants: These are less common forms of HRT and are typically reserved for women who cannot or prefer not to take HRT in other forms. Injections are given by a healthcare provider, while implants are small pellets that are placed under the skin and release hormones over time.

The choice of HRT delivery method depends on various factors, such as personal preference, the type and dose of HRT prescribed, and medical history.

It is important to discuss the different options with a healthcare provider to determine which method is best for each individual.

Hormone replacement therapy side effects

Some of my friends experienced no side effects or only mild ones, while others may have more severe symptoms. Here are some potential side effects of HRT:

1. Breast tenderness
2. Nausea
3. Bloating
4. Headaches
5. Mood changes
6. Vaginal bleeding
7. Fluid retention
8. Increased risk of blood clots
9. Increased risk of stroke
10. Increased risk of breast cancer
11. Increased risk of endometrial cancer (when taking estrogen-only therapy without progestin)

It’s important to note that not all women will experience side effects from HRT, and the risks and benefits of HRT should be carefully considered before starting treatment.

Women who have a history of breast cancer, endometrial cancer, blood clots, or stroke may not be good candidates for HRT.

A healthcare provider can help determine whether HRT is an appropriate treatment option and what type of HRT is best suited for each individual.

HRT: Myths and Misconceptions Debunked

There are several myths and misconceptions surrounding hormone replacement therapy (HRT), which can lead to confusion and fear about the treatment. Here are some common myths and misconceptions about HRT:

Myth: HRT is only used to treat hot flashes and other menopausal symptoms.

Fact: While HRT is commonly used to alleviate menopausal symptoms, it can also be used to treat other conditions, such as osteoporosis.

Myth: HRT is dangerous and can cause breast cancer.

Fact: While HRT has been associated with an increased risk of breast cancer in some studies, the risk is small and depends on factors such as age, family history, and the duration of HRT use. It’s important to discuss the potential risks and benefits of HRT with a healthcare provider.

Myth: HRT is only for women who have had a hysterectomy.

Fact: While women who have had a hysterectomy can take estrogen-only HRT, women who have not had a hysterectomy can take combined estrogen and progestin HRT to protect against uterine cancer.

Myth: HRT is only for women in their 50s and 60s.

Fact: HRT can be prescribed to women of any age who are experiencing menopausal symptoms or other conditions that may benefit from hormone therapy.

Myth: HRT will make women gain weight.

Fact: While some women may experience weight gain while taking HRT, it is not a guaranteed side effect and can often be managed with lifestyle changes.

Conclusion:

After doing all this research I realised is, its must very difficult to go through all this for an individual. I mean I do not ever have reached to this point but I am scared and overwhelmed.

So imagine how other unsupported women's must be feeling?

Well, just to connect with females in London (UK). I have created a meet up group. I am calling it “Language of Girls”

If you live in London and want to connect, please feel free to comment below and join the meetup group.

In conclusion, hormone replacement therapy (HRT) is a treatment option that can alleviate menopausal symptoms and other conditions related to hormone imbalances.

However, like any medication, HRT can have both benefits and potential side effects. It is important to discuss the potential risks and benefits of HRT with a healthcare provider and determine the best type of HRT and delivery method for each individual.

Additionally, there are several myths and misconceptions surrounding HRT, and it is important to separate fact from fiction when considering this treatment option.

Ultimately, the decision to use HRT should be based on an individual’s unique medical history, symptoms, and preferences.