Hormone Replacement Therapy - Who Should Go For It?

Hormone replacement a therapy used to treat symptoms of menopause by restoring the balance of estrogen and progesterone by administering it.

Forms of Hormonal Therapy

Local therapy which includes creams, pessaries, and rings; systemic therapy in the form of oral drugs, transdermal patches, gels, and implants. Women who do not have womb take combined estrogen and progesterone hormones in the form of pills.

Effect of Menopause and How Hormone Replacement Therapy Helps
Menopause affects urogenital system causing atrophy of mucosal lining of urethra, vagina, and vulva leading to dryness and reduced vaginal secretions. It affects bones in which metabolism takes place causing progressive bone loss. It increases the risk of heart disease. By starting with hormone replacement therapy, most of the menopausal symptoms gets relieved like hot flushes, irregular menses, night sweats, mood swings, loss of libido, osteoporosis. It is believed that women who start hormone replacement therapy may develop cancer in future, but still, research is going on.

Who should go for it?

• Menopausal women who suffer moderate to severe hot flushes, loss of libido, urogenital problems, psychological issues such as anxiety and mood swings
• Menopausal women who have severe joint pain or pain all over due to decreased bone mass
• Women who got menopause early (before the age of 40)
• Women who had their ovaries removed

Hormone replacement therapy is carefully selected for those women who are at low risk to develop heart disease and breast cancer.

Guidelines for Menopausal Women Receiving Hormone Replacement Therapy

1. Menopausal women who have undergone hysterectomy can receive estrogen replacement alone.
2. Menopausal women, who have a uterus, receive a combination of estrogen and progestogen to prevent endometrial cancer.
3. In menopausal women, who experience moderate to severe vasomotor symptoms, the duration of hormone replacement therapy use will optimally be less than 5 years.
4. For menopausal women, who suffer vaginal dryness due to less vaginal secretion, intravaginal estrogen preparation is given.
5. Hormone replacement therapy doesn’t improve loss of libido; however, if it is disturbing most, transdermal estrogen is given.
6. To reduce the longer use of hormone replacement therapy, lower doses of both estrogen and progestogens is suggested.

Can Hormone Replacement Therapy be given to Older Women?

Yes. Women who had menopause 10-15 years back can go for hormone replacement therapy, but the benefit is quite less compared to younger age group. Possible risk of heart disease and cancer should be kept in mind before prescribing it to older women.

Risk/Side-effects of Hormone Replacement Therapy

1. Breast cancer
2. Endometrial cancer
3. Thromboembolism Heart disease
4. Breast tenderness
5. Nausea Bloating

Treatment Regimen

Combination hormone replacement therapy regime is given by using lower doses of estrogen and progestin.