HORMONE REPLACEMENT THERAPY: EMPOWERING WOMEN TO EMBRACE THE MENOPAUSE JOURNEY
Welcome to my blog, where we delve into the world of menopause and explore the empowering choices available to you. Today, let’s shed light on Hormone Replacement Therapy (HRT) and its impact on managing menopausal symptoms.
By the end of this article, you’ll have a better understanding of the different types of HRT, its benefits, potential risks, and the burning question – does HRT cause weight gain?
What is Hormone Replacement Therapy (HRT)?
HRT, also known as hormone therapy, is a treatment that helps alleviate menopausal symptoms by supplementing the body with hormones that decline during this transition. It involves replacing the hormones, such as oestrogen and progesterone, that your ovaries no longer produce in sufficient amounts.
Types of Hormone Replacement Therapy:
There are several different options available to women who wish to take HRT. They include patches, tablets and topical gel or spray, applied to the skin.
For convenience, many women prefer patches or gels, and taken in this form they do not increase the risk of blood clots.
Cyclical Combined HRT:
– If you are still having periods or it is less than a year since your last period and experiencing menopausal symptoms, you may be advised to use a ‘cyclical combined HRT’.
– This type of HRT involves taking both oestrogen and progestogen hormones in a cyclical pattern, mimicking the natural menstrual cycle.
– You take oestrogen every day and progestogen is added in for 14 days of each 28-day cycle. This causes a regular bleed, every 28 days. This bleed isn’t a true period, as HRT does not cause ovulation. The progestogen causes the lining of the womb to build up. This is then shed as a ‘withdrawal’ bleed every 28 days when the progestogen part is not taken.
– It is recommended for women who still have their uterus.
– Progestogen reduces the risk of cancer in the womb (endometrial cancer).
Continuous Combined HRT:
– You are considered postmenopausal if your periods have stopped for a year or more. You can then take a ‘continuous combined HRT preparation’.
– Continuous Combined HRT involves taking both oestrogen and progestogen hormones every day without a break.
– It is suitable for women who have been taking cyclical combined HRT for at least a year or it has been at least one year since your last menstrual period.
– You may experience some irregular bleeding in the first 3-6 months. Please consult with a doctor if bleeding continues after 6 months or if you suddenly start bleeding again, after a time of no bleeding.
Oestrogen HRT:
– Oestrogen HRT, as the name suggests, involves taking only oestrogen hormones.
– It is typically prescribed to women who have undergone a hysterectomy.
– Progestogen is only required to stop the lining of the womb from building up. If your womb has been removed then progestogen is no longer needed.
Vaginal Oestrogen Cream and Other Topical Preparations:
– Vaginal oestrogen cream and other topical preparations are applied directly to the vagina to relieve specific symptoms like dryness and discomfort and/or bladder symptoms.
– They tend to have a more localised effect.
– These may be suitable for women who can’t take other forms of HRT.
– They can also be used in combination with other forms of HRT.
– More readily available from pharmacies.
Testosterone:
– Testosterone replacement therapy may be considered for women who experience a significant decline in testosterone levels during menopause.
– It comes in a gel form.
– It can help improve energy, libido, and overall well-being but this is not it’s licensed usage ie it is not formally regulated for this use and can only be prescribed by a specialist.
Benefits of HRT::
HRT is considered a safe and effective treatment for the majority of healthy women with menopausal symptoms.
Menopausal Symptoms Usually Improve:
– HRT effectively tackles hot flashes, night sweats, mood swings, vaginal dryness, and reduces recurrent urine infections, helping you regain control and feel more like yourself.
Reduced Risk of ‘Thinning’ of the Bones (Osteoporosis):
– HRT can help prevent bone loss and reduce the risk of osteoporosis and fractures, a common concern during menopause.
How long does HRT take to work?
The benefits of HRT vary from person to person. Some women experience relief from symptoms within a few weeks, while others may require a few months. Patience is key, as your body needs time to adjust to the new hormone levels.
You will need to try HRT for about 3 months to see if it helps with symptoms. If it doesn’t you may need to change the dose or try a different brand or type of HRT.
Can you take HRT for the rest of your life?
The duration of HRT depends on your individual circumstances and there is no upper time limit. Some risks can increase the longer you take it. Therefore it’s important to discuss with your doctor to determine the most suitable treatment plan for you.
In some cases, HRT may be prescribed on a short-term basis, while for others, it can be continued long-term. It is recommended to reduce HRT gradually, to reduce menopausal symptoms recurring.
Risks of HRT:
As with all medication, there can be side effects but these are uncommon with HRT. They can include:
– When initially taking HRT you may feel nauseous, and experience some breast discomfort or leg cramps. These tend to reside within the first few months.
– You may see some skin irritation due to HRT skin patches and gels.
– An increase in migraines or headaches when taking HRT. Changing to patches or gel rather than tablets can help.
Clots in the Veins (Venous Thromboembolism):
– A type of blood clot that can cause deep vein thrombosis (DVT).
– If the clot travels to your lung it is known as a pulmonary embolism (PE).
– DVT and PE together are known as venous thromboembolism.
– HRT, especially those containing oestrogen and progestogen (combined), can slightly increase the risk of blood clots in the veins. However, the overall risk remains low.
– Other risk factors include, a previous history of a clot or lifestyle choices.
Breast Cancer:
– Studies have shown a slight increase in the risk of breast cancer with long-term use of HRT and any increased risk can depend on the type of HRT taken and duration. However, the risk is small and needs to be weighed against the benefits.
– HRT should be offered to all women going through early menopause ie before the age of 45, as it helps protect against osteoporosis.
– There is little or no change in the risk of breast cancer if taking oestrogen-only HRT.
Cancer of the Womb:
– Taking oestrogen alone without progestogen can increase the risk of cancer in the womb. However, this risk can be minimised by combining both hormones.
– For safety always consult your doctor if you have any abnormal bleeding which starts after taking HRT.
Heart Disease and Stroke:
– The impact of HRT on heart disease and stroke risk is complex and varies depending on individual factors, such as age, medical history and type of HRT. Discussing your medical history with your doctor is crucial to assess the potential risks.
Does HRT cause weight gain?
Weight gain is a common concern among menopausal women. While HRT may lead to some fluid retention initially, it is not known to cause significant weight gain. Leading a healthy lifestyle that includes a balanced diet and regular exercise can help manage weight during menopause.
Conclusion
HRT can be a powerful tool for managing menopausal symptoms and improving your quality of life. By understanding the different types of HRT, their benefits, and potential risks, you are better equipped to make informed decisions about your menopause journey.
Due to my own medical conditions and other factors, I haven’t tried HRT but I am willing to discuss options as part of a coaching session.
Remember, every woman’s experience is unique, so consult with your doctor or coach to find the best approach for you. Empower yourself and embrace this new chapter with confidence and vitality!
