What is HRT?
Different options for treating menopause
The best piece of advice you can possibly get with regards to choosing a treatment option is that you should choose one that’s right for you. You need to balance the benefits of each option with the risks of each option, you decide!
Educate yourself and arm yourself with as much information as possible. At The Menopause Hub we can help and advise you, but there are plenty of solutions out there.
And remember, you do not have to commit to any particular treatment option forever (though some women choose to) because all therapies can be safely discontinued at any point.
When deciding what treatment option is best for you, consider the following:
Your symptoms of menopause and the severity of them
Any underlying health issues and your general physical wellbeing
Your family history
Your lifestyle
Your personal preferences with regards to medicine
Your ability to accomplish your goals with your chosen management style
Any side effects of your medication
The proven treatment option
HORMONE REPLACEMENT THERAPY (HRT)
HRT is the most common type of treatment for the menopause. It is the most effective treatment available to improve your symptoms and it can also work to reduce the risk of both osteoporosis and cardiovascular disease.
Unfortunately over the last ten years or so HRT has gained something of a negative press, leaving some women concerned about the therapy. The negative reports are due to a large trial that was reported in 2002 (called the Women’s Health Initiative (WHI) Study), which has since been shown to be flawed.
The WHI actually studied women who are older (in their 60s) and were given types of HRT that are no longer prescribed these days. Interestingly, the authors of this study have recently apologised in a mainstream medical journal (NEJM) as they admitted that people misinterpreting the results of their study is one of the main reasons that women are unnecessarily worried about taking HRT.
For the majority of women under the age of 60 years, the benefits of HRT really do outweigh any risks. HRT can provide you with positive effects to your health, especially your bones and heart. HRT is also recommended for young women to take following an early menopause and they need to take it until they are at least 51 years old.
All types for hormone replacement therapy contain an oestrogen hormone. Taking HRT replaces the oestrogen that your ovaries no longer make after the menopause. Even low levels of HRT can have benefits in your body and improve your symptoms. The type of oestrogen usually used nowadays is 17 beta oestradiol which is the same type of oestrogen as the one you are lacking.
Many women feel confused about the different types of HRT and also about the benefits and risks. It is important that your individual health is taken into consideration by your doctor when discussing HRT and an individualised approach should be taken.
HRT is the most effective treatment available to relieve symptoms caused by the menopause such as hot flushes, night sweats, mood swings and bladder symptoms.
There is no set length of time that you should take HRT for and some women decide to take HRT for many years. It is usually an individual decision between yourself and your doctor regarding the length of time you take HRT for.
If your symptoms return when you stop taking HRT this is not an effect of taking hormones, this is because you would still be having menopausal symptoms at that time anyway.
HRT is not a contraception. If you still require contraception, then you should talk to your doctor about the options available to you.
FORMS OF HRT
HRT is available as tablets, skin patches or gel. The tablets and gel are usually taken/or applied to your skin daily and the patches are usually changed twice a week.
If you still have a womb (uterus) it is important that a progestogen (a progestogen is a synthetic type of progesterone) is taken with the oestrogen. When you take oestrogen the lining of your womb builds up and can increase your risk of cancer. However, taking a progestogen reverses this risk.
There are many different preparations of HRT and if one type does not suit you then it is likely that another type will.
If you are considering taking HRT, then the lowest effective dose should be taken and you should have regular follow-ups to decide whether you still need HRT. If you are still experiencing menopausal symptoms on HRT, then your dose will probably be increased.
BENEFITS OF HRT
Many women wait until their symptoms are really troublesome or even unbearable before starting HRT. However, taking HRT early will make a difference to your symptoms (and quality of life) and also lead to a greater improvement in your heart and bone health.
SHORT TERMS BENEFITS AND LONGER TERM BENEFITS
HRT works really well to ease the symptoms of the menopause and will give you relief. That is the short term benefit of HRT. Many women find that all the symptoms of the menopause improve within a few months of taking HRT and feel that they have their “old life” back again. They often notice that their sleep improves, their mood improves and their concentration recovers. They also often notice that their energy is much greater than it was before they started taking HRT.
HRT usually works to stop hot flushes and night sweats within a few weeks.
In addition, HRT will reverse many of the changes around your vagina and vulva, usually within 1-3 months. However, it can take up to a year of treatment in some cases. You may also find that any aches or pains in your joints improve and that the texture of your hair and skin improves when taking HRT. HRT is a safe and effective treatment for most healthy women with symptoms who are going through the menopause at the average age in the UK (about 51 years). The benefits and risks of HRT will vary according to your age and any other health problems you may have. You will have the opportunity to discuss any potential risks of HRT with your doctor in detail at The Menopause Hub.
Longer term replacing your lost hormones via HRT will give you greater protection for heart health, bone health and cognitive function.
YOUR RISK OF DEVELOPING OSTEOPOROSIS WILL REDUCE
Taking HRT can prevent and reverse the bone loss that occurs, even for those women who take a lower dose. This means that taking HRT reduces your risk of having a fracture due to osteoporosis. This benefit is maintained during treatment, but does reduce when you stop taking HRT.
YOUR CARDIOVASCULAR DISEASE RISK WILL REDUCE
HRT gives greater protection for heart health. Heart disease and stroke are the #1 killer of women in Ireland & worldwide.
1 in 2 Irish women will die from cardiovascular disease.
Irish women are 7 times more likely to die from cardiovascular disease than breast cancer.
5,000 Irish women die from cardiovascular disease each year.
That’s 5,000 families without a mother, sister, aunt, gran – a loved one!
That’s an average of one woman every 2 hours.
If you are under 60 years old, HRT does not increase your risk of heart disease. In addition, it does not affect your risk of dying from heart disease.
There is some evidence that taking HRT, especially HRT with oestrogen alone, reduces your risk of developing cardiovascular disease (meaning heart attacks and strokes). The benefits are greatest in those women who start HRT within ten years of their menopause.
HRT can also lower your cholesterol levels which is beneficial for your heart and body.
YOUR COGNITIVE FUNCTION WILL BE PROTECTED
HRT may protect cognitive function. A new study shows how hormone replacement therapy may help prevent Alzheimer’s disease in millions of women at risk of developing the condition, research suggests.