The levels of female sex hormones estrogens start decreasing gradually in a woman's blood by the age of 45-50 years causing menopause. It might provoke the development of vegetative, psycho-emotional and urogenital disorders such as hot flashes, night sweats, insomnia, mood swings, loss of calcium from the bones and others. Hormone replacement therapy or HRT is aimed at restoring the deficiency of estrogens with the help of medications containing synthetic hormones.
So what does hormone replacement therapy do?
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HRT helps to reduce and eliminate the symptoms of menopause. It also decreases the risk of development of certain consequences of menopause such as osteoporosis, heart diseases, atrophic vaginitis (drying, thinning and inflammation if the vaginal walls) and some others.
What medications are used for HRT?
HRT medications contain two types of sex hormones – estrogen and progesterone. The former helps to compensate the decrease in the production of natural estrogens, the latter protects the endometrium from the proliferative effect of estrogens, in other words it reduces the risks for endometrium cancer.
Hormones can be administered not only in the form of pills, but also in the form of hormonal patches, subcutaneous implants, vaginal suppositories, etc.
Who needs HRT?
Despite the fact that HRT can relieve the symptoms of menopause, the use of hormones is not always necessary and, most importantly, safe in menopause. Such therapy is indicated in the following cases:
- To reduce hot flashes and night sweats if they are too disturbing and interfere with a woman's everyday life;
- To relieve such symptoms as severe dryness and discomfort in the vagina, pains during sex, urinary incontinence;
- If there is a high risk of osteoporosis and bone fractures and also if by the time menopause begins a woman already has symptoms of the loss of calcium from the bones or has had bone fractures associated with osteoporosis.
HRT is not administered for the treatment of depression associated with menopause; antidepressants are used for this purpose.
Are there any contraindications to HRT?
HRT cannot be used in women with:
- Breast, ovarian or endometrial cancer;
- Serious liver disease or liver failure;
- Increased levels of triglycerides in the blood;
- Deep vein thrombosis;
- Uterine fibroids;
- Untreated hypertension;
- A history of stroke or heart disease.