Considering Hormone Replacement Therapy should be an individualized risk assessment based on the woman’s symptoms, medical history, and preferences.
What is Hormone Replacement Therapy (HRT)?
HRT refers to both estrogen-only therapy or combined estrogen-progesterone therapy. HRT is available in various forms, including oral medications and patches.
When is HRT medically indicated?
HRT is one of several medical treatment options and involves using of hormones alleviate the symptoms of moderate to severe menopause-related hot flashes and night sweats. In some cases HRT may have greater risk than benefit in women who are age 50-59, within the first ten years of menopause, and who are experiencing bone loss.
Estrogen Only Therapy
Estrogen only is recommended only for women who have had a hysterectomy or removal of the uterus. There is no need for progesterone, which is used protect the uterus from the potential risk of endometrial cancer.
Combined Estrogen - Progestogen Therapy
For women with their uterus, combined estrogen-progestogen therapy (similar to birth control pills) are used protect the uterus from the potential risk of endometrial hyperplasia and cancer.
Dosage and Duration of Hormone Treatment
Generally we use the lowest effective dose and for the shortest duration necessary to achieve treatment goals. Typically we consider stopping hormone replacement therapy for women above age 60 or more than ten years after menopause onset because the risks of HRT towards cardiovascular health may outweigh the benefits.
What are Bio-Identical Hormones?
The term “bio-identical hormones” refers to hormones that have a molecular structure identical to the hormones naturally produced by the human body. These hormones are derived from plant sources and are processed to be chemically identical to endogenous hormones.
Physicians and even the North American Menopause Society (NAMS) do not support the use of “bio-identical hormones” as they are often made in compounding pharmacies and are not subjected to the same rigorous testing for safety and efficacy.