Hormone replacement therapy is a medical treatment that supplements the body’s own hormones — most commonly estrogen and progesterone, and sometimes testosterone. The therapy delivers these hormones in various forms: pills, skin patches, gels, sprays, or vaginal creams and tablets.
During the years leading up to menopause (a phase called perimenopause), estrogen and progesterone levels fluctuate and decline. This volatility can trigger a wide range of physical and emotional symptoms, including hot flashes, night sweats, weight gain, vaginal dryness, irregular periods, irritability, and insomnia.
At menopause, estrogen levels drop to a permanently lower baseline, laying the groundwork for bone loss as well as cardiovascular and metabolic changes. This is why many healthcare professionals recommend HRT to replace estrogen as it declines.
“Not everybody needs the same hormone in the same dose at the same time.”
Estrogen may be the most commonly prescribed hormone for menopause and perimenopause; it directly addresses most of their hallmark symptoms, particularly hot flashes and night sweats. For women who still have a uterus, progesterone is typically prescribed alongside estrogen to help protect the uterine lining from excessive growth, which is associated with endometrial (uterine) cancer. Progesterone can also influence the brain’s GABA receptors, helping promote relaxation and relief for menopause-related anxiety and insomnia.
Proponents of HRT note that the therapy can be useful for more than just menopausal symptoms.
“Estrogen has more than 400 purposes in the body,” says Karen Kaufman, MD, a board-certified obstetrician and gynecologist, and the medical director of MIORA in Colorado. “It’s involved in bone health, joint health, brain health, heart health, vaginal health — really almost every system.”
Most experts agree that HRT works best and is least risky when clinicians prescribe the lowest effective doses, tailoring treatment to a person’s symptoms, health history, and risk factors. In practice, that means hormone therapy is rarely a one-size-fits-all prescription.
“It’s really a personalized approach,” Kaufman says. “Not everybody needs the same hormone in the same dose at the same time.”
Understanding HRT
If you’re considering hormone replacement therapy (HRT), you probably have questions. We asked clinicians and hormone specialists for answers about how HRT works, what its real risks and benefits are, and how to decide whether it’s right for you at “A Balanced Approach to Hormone Replacement Therapy,” from which this article was excerpted.
Comments (0)