Hormone Replacement Therapy

By: Amy Bingham
By: Amy Bingham

The Medical Center hosted a forum this week featuring the topic of hormone replacement therapy.

Three panelists were on hand to answer questions for the overflow crowd.

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What Is Hormone Replacement Therapy?

Doctors usually prescribe HRT, which combines estrogen and progestin (a form of progesterone). Estrogen can and should be used alone (estrogen replacement therapy or ERT) for women who have had their uterus, including the cervix, removed (by hysterectomy).

Estrogen alone comes in many forms. You can use the pill or tablet form, vaginal creams, vaginal ring insert, implants, or shots. There are also patches that stick to the skin.

The body absorbs estrogen from the patch through the skin. Progestin usually is taken in pill form, sometimes in the same pill as the estrogen. It is also available as an IUD (intrauterine device), a vaginal gel, and shots.

The form your doctor suggests may depend on your symptoms. For instance, estrogen creams are used for vaginal dryness.

The vaginal ring insert treats vaginal dryness and may help urinary tract symptoms, such as problems holding urine. Pills or patches, however, are used to provide additional relief from menopause symptoms such as hot flashes or to prevent bone loss.

There are different schedules for taking HRT in pill form. You could take estrogen every day for a set number of days, add progestin for 10-14 days, and then stop taking one or both for a specific period of time.

You would repeat the same pattern every month. This cyclic schedule often causes regular monthly bleeding like a light menstrual period.

Or you could take estrogen and progestin together every day of the month without any break. This continuous pattern can stop monthly bleeding after about six months of treatment. However, problem spotting may continue for longer. Talk with your doctor about the schedule that is best for you.

The Pros and Cons

Pros

  • Reduce the risk of osteoporosis.
  • Relieve hot flashes and night sweats.
  • May reduce the risk of heart disease.
  • May improve mood and psychological wellbeing.

Cons

  • Increases the risk of cancer of the uterus (endometrial cancer).
  • Can have unpleasant side effects, such as bloating or irritability.
  • HRT and ERT may increase risk of breast cancer; long-term use may pose the greatest risk.
  • In women at risk of blood clots, HRT and ERT may be dangerous.

Source: http://www.aoa.dhhs.gov/aoa/pages/agepages/hormone.html (National Institute on Aging).


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