Hormone replacement therapy

Hormone replacement therapy (HRT) is a medical technique that replaces two female hormones that is no longer produced in the woman's body due to menopause. These hormones include:

  • Oestrogen: the oestrogen used in HRT is extracted from plants or from the urine of a pregnant horse
  • Progesterone: HRT uses a synthetic form of progesterone named progestogen since it is much easier for the body to absorb

Types of HRT

Although there are close to 60 different HRT preparations, the three main types are as follows:

  • Oestrogen-only HRT:Oestrogen-only HRT is generally administered for those women whose womb and ovaries have been removed during procedures such as hysterectomy. Intake of progestogen is not required since there will be no risk of endometrial cancer
  • Cyclical HRT: Cyclical HRT (or sequential HRT) is recommended for those women who show symptoms of menopause but continue to have their periods. There are two kinds of cyclical HRT:
  • Monthly HRT: Wherein oestrogen is administered daily while progestogen is given at the end of the menstrual cycle for 14 days. Monthly HRT is normally advised for those women who have regular periods. They will continue to get their monthly periods until the menopause kicks n and causes them to stop.
  • Three-monthly HRT: Wherein you are given oestrogen daily and progestogen for 14 days, every 13 weeks. This technique is given for those women who experience irregular periods. For its administration, one must get a period every three months so as to realize when the periods stop naturally.
  • Continuous combined HRT:Continuous combined HRT is normally adminstered for post-menopausal women. A woman is considered to be post-menopausal if she has not had a period for over a year. This type of HRT involves administering both oestrogen and progestogen daily without a break.

Unsuitable candidatesfor HRT

HRT is normally not recommended if you:

  • Are pregnant
  • Have heart disease and stroke
  • Have high blood pressure
  • Have liver disease
  • Have breast cancer, ovarian cancer etc
  • Have blood clots

How is HRT given?

There are numerous ways as to how hormone replacement therapy (HRT) can be given such as:

  • In the form of tablets
  • As a patch you stick on your skin
  • As a cream or gel
  • As an implant

Side effects

Both hormones oestrogen and progestogen pose certain side effects which usually improve over time in many cases. In such a scenario, it is best to consult your doctor who would recommend:

  • Changing the dose of HRT
  • Switching to a different method of HRT intake
  • Changing the type of HRT you are given

Side effects of oestrogen

  • Headaches
  • Breast tenderness or swelling
  • Nausea
  • Fluid retention
  • Bloating
  • Leg cramps
  • Indigestion

Side effects of progestogen

  • Headaches
  • Mood swings
  • Fluid retention
  • Breast tenderness
  • Acne
  • Backache
  • Depression