Hormone replacement therapy, also known as HRT, is a very controversial subject when it comes to women’s health issues. Some doctors believe HRT can do more harm than good, others recommend specific types of HRT because they believe they are safer, and still others fall somewhere in the middle of the discussion. This article will explain the basics of HRT and why some women chose to have it. If you are considering HRT, you’ll need to talk to your doctor or doctors to decide what is best for your own health.
Hormones are chemicals that act as messengers inside our bodies. Some hormones have specific functions in reproductive health. The primary male sex hormone is testosterone. The primary female sex hormones are estrogen and progesterone, although testosterone is needed by the body to make estrogen. For more information about how these hormones function in the body, read the articles on estrogen, progesterone, and testosterone.
By mid-life, a woman’s reproductive system starts to shut down and the levels of these hormones begin to fluctuate. This period of adjustment is known as pre-menopause or perimenopause. When the hormones levels become low enough, a woman stops having her period and is said to have reached menopause. You can read more about this time of adjustment in the article on menopause.
Why consider HRT?
Hormone replacement therapy is typically triggered by the onset of the symptoms of menopause or perimenopause. When confronted with hot flashes, night sweats, mood swings, and depression, some women chose to “tough it out” while others try to help their bodies adjust by taking supplements of the hormones that their bodies are lacking. Other symptoms that can be caused by low hormone levels include dryness and thinness of the tissue in the vagina (birth canal) which can make sexual intercourse painful. The risk of osteoporosis, which is a thinning and weakening of the bones, may also be increased by low estrogen levels. Since these symptoms are caused by a lack of certain hormones, so it stands to reason that replacing that hormone would eliminate the symptoms. That is the basic purpose for hormone replacement therapy. But the decision to use HRT and what type of HRT is right for you is much more complicated.
Hormones used for HRT
Hormones that can be replaced include estrogen, progestin, and testosterone. Standard HRT for postmenopausal women includes either estrogen alone or estrogen in combination with progestin. One common traditional estrogen used for HRT is known as CEE or conjugated equine estrogens. This replacement hormone is made from the urine of horses and is often sold under a number of brand names including Premarin ®.
There are many ways hormones can be taken:
• Systemic therapy - Hormones are given to the whole body either through a patch or as pills that are absorbed either through the skin or in the digestive system.
• Topical therapy – Hormones mainly reach areas near where they are given, rather than reaching the whole body. Creams, tablets, or rings containing very small doses of estrogen are sometimes inserted into the vagina to relieve symptoms of vaginal dryness or thinness. This method can help specific symptoms, but is less effective against symptoms felt throughout the body, such as hot flashes.
Doctors are concerned because HRT use has been linked with increased risks of a variety of medical conditions. An article to follow will explain how bio-identical hormone replacement therapy differs from tradition HRT.
Further reading: Hormone Replacement Therapy – Pros and Cons
National Institutes of Health: Medline Plus
American Cancer Society
National Heart Lung and Blood Institute
About.com: Women’s Health
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