Women above 40, and who have entered menopausal phase, must have heard of or about the hormone replacement therapy (HRT). It is often prescribed to relieve menopausal symptoms, to prevent or treat osteoporosis and also to protect the womb. Majority of menopausal symptoms stem from the natural decline in estrogen (one of the female hormones) levels. The rationale of this therapy is to reverse its decline in the body to improve the menopausal symptoms. Like most things in life, HRT comes in a mixed bag. There are pros. There are cons. And HRT usage needs informed analysis and decision-making. And we are here to help you reach there. So, how exactly does this HRT work? What are its risks, benefits, and drawbacks? Let's dig deeper and lay all those doubts to rest.
What is hormonal replacement therapy?
The name says it all. It replaces or supplements women with female hormones (estrogen and progesterone) that are lost due to menopause. The therapy usually comprises of components that mimic the hormones - estrogen and progestin (a synthetic version of progesterone). However, only estrogen is prescribed to women who have undergone hysterectomy (surgical removal of the womb). The usual indications include:
To treat vasomotor symptoms like hot flashes, night sweats
To treat genitourinary syndrome like vaginal dryness, recurrent urinary tract infections, and painful urination
To prevent osteoporosis
HRT is available in many forms, including pills, implants, gels, and skin patches. The hormones can also be given via contraceptive devices inserted into the womb by a doctor.
Hormonal replacement therapy: The benefits
The components mimicking estrogen and progesterone relieve prominent menopause-related symptoms. Estrogen relieves vasomotor symptoms, including hot flashes and night sweats. It also helps in preventing or treating osteoporosis. Progesterone prevents the abnormal proliferation of cells in the lining of the uterus (womb). Progesterone can also provide relief from symptoms such as sleep disturbance and mood instability. It offers protection to the breast tissues. The beneficial effects of HRT extend beyond just relieving menopausal symptoms. It also reduces the risk of cardiovascular diseases.
Hormonal replacement therapy: The cons
Some women may experience side effects while on therapy, including fluid retention, breast tenderness, headaches, mood changes, and uterine bleeding. Women are closely monitored during the therapy. HRT may show an increased risk of breast cancer, stroke, heart disease, and deep vein thrombosis. Discussion with a specialist or healthcare provider is crucial when considering the long-term use of HRT to analyze if its benefits outweigh its risks.
Hormonal replacement therapy benefits bone health
During menopause, estrogen deficiency causes an imbalance of the bone-building process, leading to bone loss. HRT increases estrogen levels and bone mineral density, preventing bone loss. Hence, it reduces the risk of developing osteoporosis. HRT also strengthens the bone and reduces the risk of vertebral and hip fractures in women with osteoporosis. A study has shown that HRT rapidly improves spinal bone mineral density in the first six months of therapy. The bone mineral density peaks at three years with an overall increase of 4%. HRT eases the menopausal transition by assuaging its debilitating symptoms. HRT promises bone health, emotional health, and overall well-being in menopausal women. Do not let the fear of fractures or bone loss or even menopause itself stand in the way of an adventurous after-40 life. Be it a bike ride along the shore or hikes with friends in nature reserves. It is your very own after-40 journey. Make it fearless.
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References
- Harper-Harrison G, Shanahan MM. Hormone Replacement Therapy. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493191/. Accessed on 29 February 2024.
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