If you’re considering Hormone Replacement Therapy to help alleviate menopause symptoms, it’s vital that you consult with your physician first to learn which treatment option is healthiest for you. Many forms of HRT are available, so do your research before starting the treatment.
The two main hormones in HRT are estrogen (the female sex hormone needed for puberty, the menstrual cycle, pregnancy, and bone health) and progestogen (a synthetic drug that mimics the progesterone hormone). Some treatments combine both hormones, while others may only use estrogen (this is for women who have had a hysterectomy).
Your HRT treatment depends mainly on what stage of menopause you are in. Cyclical HRT (also known as sequential HRT) is designed for women who still have a period along with their menopausal symptoms. It can be taken every day during the last 14 days of your cycle, once a month. It’s mostly recommended for women who experience regular periods. The other option is the 3-month HRT, which applies to women with irregular periods occurring every three months.
The combination of progestogen and estrogen is best used for post-menopausal women (defined as not having a period for one year) and is taken daily without a break.
There’s no time limit for taking HRT, but most patients stop the treatment once their menopause symptoms pass. Here’s a look at the different forms of HRT that are available for alleviating the discomfort of menopause:
Tablets: This is one of the most common forms of HRT. It’s a convenient method since it is usually prescribed for taking once a day. However, as with any medication, there are certain risks involved, and the risk of blood clots tends to be a little higher with tablets.
Estrogen gel: This popular form of HRT is a gel rubbed into the skin once a day. Many women prefer this method over swallowing a tablet. The risk for blood clots is also lower with gels. However, if you have not had a hysterectomy and are using this product, it is recommended that you take progestogen separately to avoid the risk of uterine cancer.
Skin patches: Hormone Replacement Therapy patches come in various sizes and doses and are usually placed on the lower abdomen or upper buttocks. They are available as estrogen alone or in combination with progestogen and are changed every few days. Many patients prefer the patch’s convenience since it lasts several days. In addition, it’s good for relieving symptoms of hot flashes, night sweats, mood swings, and vaginal dryness. The risk of blood clots is also less, and the patch doesn’t cause the common side effect of indigestion that you may experience with the tablet form of HRT.
Vaginal estrogen: Vaginal estrogen is primarily used to alleviate vaginal dryness, one of the leading causes of uncomfortable intercourse for menopausal women. It is available as a cream, pessary, or ring placed inside the vagina. It does not carry the risk of breast cancer and can be used without a progestogen supplement.
Implants: HRT implants are the size of a small pellet and are inserted under the skin (after it has been numbed) in the abdominal area. The implant gradually releases estrogen into your system for several months before it will need to be replaced with a new pellet. Again, if you have not had a complete hysterectomy, you must supplement the implant with some form of progestogen.
Testosterone: Your physician will typically administer testosterone through an injection or gel, although it can also be described as a patch or a pellet inserted under the skin. Treatment is started in low doses that are gradually increased over time. It’s primarily used with other forms of HRT to restore the sex drive in women at the end of menopause. Sometimes, there are side effects, such as acne or unwanted hair growth.
HRT SPRAY: Sprays are a newer form of HRT designed to deliver estrogen to the body. It is usually applied once a day and absorbed into the skin the same way the matches and gels work. However, if you still have your uterus and ovaries, you will need to supplement the spray with progestogen prescribed by your physician.