What is Hormone Replacement Therapy?
Hormone Replacement Therapy (H.R.T.) is a treatment
used to help ease and even prevent some of the uncomfortable symptoms
women experience around the time of menopause.
H.R.T. has been known to generally improve the quality of life of those
taking it.
Everyone is individual and some women feel taking
H.R.T. isn’t necessary. It is therefore important that you have
accurate information about the treatment and the benefits before you
decide if H.R.T. is right for you.
Why might I need H.R.T.?
When you reach the menopause your ovaries produce less and less of the hormone oestrogen.
The purpose of H.R.T. is to give back your natural levels of oestrogen.
By restoring this hormone your body can deal with the problems experienced
during the menopause, such as night sweats and hot flushes.
Progestogen, which mimics another female hormone
called progesterone,
is usually given with oestrogen to protect the lining of the uterus (unless you have had a hysterectomy).
Taking progestogen means that you may have a small bleed each month,
similar to a period.
Taking two hormones together is known as a combined form of H.R.T. Your doctor will decide
what type suits you best.
Are there different types of H.R.T. available?
H.R.T. is not one medicine, but a variety of combinations,
types and dosages. Different women need different forms of H.R.T to
suit their individual needs. H.R.T. can be given in the following ways:
- Tablet form - this is the
most common type of H.R.T. and needs to be taken daily.
- Patches
- are applied
to your skin below you waist, for example, on your thigh, bottom,
hip or stomach. Oestrogen is gradually released
through the skin directly into the blood stream. Patches need to be changed every few days and each time
they are applied they may need to have a new location as irritation
can occur.
- Implants - these are small
pellets of oestrogen that are inserted into the fat under the skin.
This process is carried out with a local anaesthetic at your local doctor’s surgery or at your hospital outpatients
department. These implants last about 6 months and they are very effective
for those with a busy life style and may find remembering regular
medication a problem.
- Gels - which contain oestrogen
can be applied to the skin usually once or twice daily. After applying
the gel to your skin, oestrogen is absorbed into the blood stream.
- Vaginal treatments - these come
as pessaries (tablets inserted into the vagina) or creams which help
to ease vaginal discomfort. There is also a vaginal ring available,
which contains oestrogen and can be left in the vagina for 3 months,
where it slowly releases oestrogen into the vaginal tissues.
- Nasal spray, this is a new form and allows oestrogen
to be absorbed through the soft tissues in the nose into the bloodstream.
It will need to be sprayed into each nostril daily.
What are the benefits of H.R.T.?
H.R.T. can help :
- Stop hot flushes.
- Restore the vagina’s elasticity and natural
lubrication.
- Stop night
sweats.
- Ease depression.
- Prevent headaches or migraines
- You feel
better in yourself.
H.R.T. can also help protect against osteoporosis and long term use will also reduce the risk of fractures.
Research has suggested that women taking H.R.T. are also living longer.
In women who don’t smoke, H.R.T. can also provide some protection
against heart
disease and strokes,
if taken over a long period. Recent research also suggests that taking
H.R.T. may lower the risk of getting Alzheimer's
disease and bowel
cancer.
How long should I use H.R.T.?
To relieve the short term symptoms such as hot flushes
and night sweats, treatment for 1-2 years may be enough. However, to
help gain protection against osteoporosis and heart disease, H.R.T.
needs to be taken long term (approximately 5 years).
What are the risks?
Like all medicines H.R.T. has its disadvantages
and recent evidence shows that when H.R.T. is taken for a long period
of time (5-10 years or more) there may be an increased risk of breast
cancer and blood clotting, also referred to as Deep
Vein Thrombosis (D.V.T.). If you
are already at risk of blood clotting then H.R.T. may not be for you
and you may need special blood tests before you start on H.R.T.
All women who take H.R.T. should attend for breast
screening and check their own breasts for any lumps or abnormalities.
Those people who have more than one close blood relative with breast
cancer can still take H.R.T. as the benefits of H.R.T. outweigh the
extra risk of breast cancer, however, they should ensure they have yearly
mammograms.
For more information on breast cancer and how to check your breasts click here.
As H.R.T. is only available on prescription your
doctor will help you weigh up all risks and benefits before you begin
treatment and you can discuss any concerns you have. If you are already
taking H.R.T. and you wish to stop you should ask your doctor for advice.
Are there any side effects?
Oestrogen replacement has been prescribed since
the 1940’s and is used today by thousands of women all over the
world. Each individual may experience some side effects, some types
may cause the return of your monthly period, though there are period-free
medications available. There are several types and different doses of
H.R.T. so it may take a while to find the best one for you.
Possible side effects include:
- Breast tenderness
- Bloating, due to fluid retention
- Headaches
- Nausea
There are over 40 different combinations available,
so if one doesn’t work well for you there will be other options.
You should try each method of treatment for 3 months before deciding
if it’s suitable for you.
As with many treatments, H.R.T. is unsuitable for
some women with certain medical problems. Any questions or worries should
be referred to your G.P. or practice nurse.
Related topics
Menopause
Osteoporosis
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