Hormone Replacement Therapy

If you have hot flashes, vaginal dryness, or other symptoms of menopause, your healthcare provider may recommend hormone replacement therapy (HRT). The medicines used in HRT contain estrogen or estrogen with progestin (another hormone). It's important to note that hormone replacement therapy can increase the risk of heart attack, blood clots, stroke, and breast cancer. Women who use HRT should do so at the lowest dose that produces results, and for the shortest time necessary.

 

What Is Hormone Replacement Therapy?

There has been considerable discussion recently regarding hormone therapy to treat symptoms of menopause. Hormone therapy for menopause is also referred to as hormone replacement therapy (HRT).
 
The lower levels of hormones that occur during menopause may lead to:
 
 
To help alleviate these problems, some women receive hormone replacement therapy. The medicines used in hormone replacement therapy contain estrogen or estrogen with progestin (another hormone). Hormone replacement therapy works by replacing the natural estrogen your body loses during menopause.
 
Like all medicines, hormone replacement therapy has risks and benefits. After reading this article, talk to your doctor, nurse, or pharmacist for more information about this treatment. If you decide to use hormone replacement therapy, use it at the lowest dose possible that provides relief of your menopausal symptoms. Also, only use the therapy as long as needed -- long-term use of hormone replacement therapy can increase the possible risks involved.
 

Benefits of Hormone Replacement Therapy

Hormone replacement therapy has been shown to be beneficial in:
 
  • Reducing hot flashes
  • Treating vaginal dryness
  • Slowing down bone loss
  • Decreasing mood swings and depression.
     
Hormone replacement therapy should not be used to prevent heart attacks, strokes, memory loss or Alzheimer's disease. It's also important to know that there are other medicines available to help slow down bone loss.
 

Risks of HRT

Women who use hormone replacement therapy are at increased risk for:
 
For a woman who still has her uterus (has not had a hysterectomy), taking estrogen alone without progesterone increases her chance of getting endometrial cancer (cancer of the lining of the uterus). Adding progesterone to the hormone therapy lowers this risk. For women who have had a hysterectomy, taking estrogen alone can raise the risk of blood clots and stroke.
 

Side Effects of Hormone Replacement Therapy

Hormone replacement therapy may also cause the following side effects:
 
  • Bleeding
  • Bloating
  • Breast tenderness or enlargement
  • Headaches
  • Mood changes
  • Nausea.
     

When It Should Not Be Used

Hormone replacement therapy is not appropriate for every woman dealing with the symptoms of menopause. Women who should not use HRT include those who:
 
  • Think they are pregnant
  • Have problems with vaginal bleeding
  • Have had certain kinds of cancers, such as breast and uterine cancer
  • Have had a stroke or heart attack
  • Have had blood clots
  • Have liver disease.
     

Can Hormone Replacement Therapy Be Used for Other Conditions?

Hormone replacement therapy may be a way to get through the symptoms of menopause if taken for only a short time and in the smallest amount that produces results. However, hormones do not help prevent heart or bone disease, stroke, memory loss, or Alzheimer's disease. If you decide to use hormone replacement therapy, use it at the lowest dose that helps and for the shortest time needed. Check with your doctor every year to see if you still need HRT. Because there are both benefits and risks linked to this type of treatment, every woman should think about and discuss these issues with her doctor. The medical community is still trying to learn more about both the long-term and short-term effects of hormone replacement therapy on women's health.
 
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;