To begin, hormone replacement therapy consists of using the female hormones of estrogen and progesterone to treat the most common symptoms of menopause and aging in women. Once women’s reproductive cycles decline and their periods stop, their hormone levels drop and uncomfortable symptoms such as vaginal dryness, hot flashes, and sometimes even osteoporosis begin to arise. In order to alleviate these symptoms, doctors may prescribe hormone replacement therapy during or after menopause to replenish the patient’s estrogen and progesterone levels.
Estrogen not only prepares a child-bearing age patient’s uterus to receive a fertilized egg, but it also raises the levels of good cholesterol in the blood and directly affects how the body uses calcium, which is vital in strengthening bones. Progesterone thins the lining of the uterus to allow the endometrium, or uterine lining, to leave your body during periods. However, once you stop having periods, progesterone reduces your risk of developing cancer in your endometrium, which can build up if you are only taking estrogen.
When You Should Consider Hormone Replacement, and When You Shouldn’t
Women who have had a hysterectomy to remove their uterus are often given a low dose of estrogen in the form of a daily pill or patch, or a vaginal spray or gel ring, known as systemic hormone therapy. This treatment relieves night sweats, hot flashes, and sometimes vaginal burning, itching, dryness, or discomfort. Women who have not had a hysterectomy are usually given a combination of estrogen and progesterone or progestin, also known as combination therapy.
If you are healthy and have developed premature menopause or ovarian insufficiency (in which you stop having periods or lose normal ovarian function before age forty), are experiencing moderate to severe hot flashes or other menopausal symptoms, and have lost bone mass and cannot tolerate or benefit from other treatments, hormone replacement might be for you.
If you have a current or past history of breast, endometrial, or ovarian cancer, you should not take hormone replacement therapy. Those with a history of strokes and blood clots to the lungs or legs should not undergo hormone replacement either.