Definition

Hormonal Replacement Therapy, or HRT, is a treatment recommended by doctors to relieve the menopause symptoms in a woman. The therapy is highly effective in relieving dryness in the genital tract, changing mood swings, and moderating hot flushes. HRT also averts the risk of developing certain cancers, osteoporosis, and fractures.

HRT treatment may be either:

Estrogen-Alone Therapy: It refers to hormone replacement therapy after hysterectomy, i.e., given to women with surgical menopause or hysterectomy.

Progesterone Therapy: It is recommended for women naturally experiencing menopause.

For years, HRT is used by doctors for curing unpleasant menopause symptoms amongst women, thereby, improving their quality of life. However, at times, the treatment comes with a risk of venous thromboembolism and breast cancer. For this reason, it is important to discuss with the specialist and understand the benefits and risks associated with HRT as well as to receive an individualized managed treatment.

Benefits of Hormone Replacement Therapy

Systemic oestrogen—which may come in pill, skin patch, gel, cream or spray form—remains the most effective treatment for the relief of uncomfortable menopausal hot flashes and night sweats. Oestrogen can also ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse.

In HRT, oestrogen is taken together with progesterone in order to prevent cancer of the endometrium, the lining of the uterus. Since the cells from the endometrium do not leave the body during your monthly menstrual period after menopause, the cells may build up in your uterus and lead to cancer. Progesterone lowers that risk by thinning the lining.

Risks of Hormone Replacement Therapy

The Women’s Health Initiative or WHI conducted a clinical trial in the year 2002 to check the risks associated with 10,000 women undergoing HRT treatment for five to six years. Following outcomes were indicated in the study:

❖ 38 women on HRT as equated to 30 women who did not take the therapy were observed to develop breast cancer

❖29 women on HRT as equated to 21 women who did not take the therapy were observed to get affected by strokes

❖37 women on HRT as equated to 30 women who did not take the therapy were observed to develop heart attacks

❖ Likewise, 10 women on HRT as equated to 16 women who did not take the therapy were observed to develop colon cancer; and

❖ 10 women on HRT as equated to 15 women who did not take the therapy were observed to develop hip fractures

Henceforth, it was verified from the above study that HRT intensifies the risk of developing breast cancer from nearly 0.30% to about 0.38%, risk of developing strokes from approximately 0.21% to nearly 0.29%, and risk of having heart attacks from 0.30% to 0.37%.

Another analysis revealed an increased health risk to women commencing HRT at the age of 51 years.

Nevertheless, HRT, at present, is considered as the most successful treatment for women experiencing menopausal symptoms.

Who should avoid Hormone Replacement Therapy?

Women with these conditions should avoid HRT:

• Blood clots
• Cancer (such as breast, uterine, or endometrial)
• Liver disease
• Heart disease
• Known or suspected pregnancy
• Stroke

Should you suspect you are approaching menopause or undergoing perimenopause, consult ASC Clinic for a comprehensive evaluation. Our doctors will help you weigh the pros and cons of menopausal treatment and recommend choices based on your age, your family’s medical history, and your personal medical history.