Hormone replacement therapy is the administration of artificial progestogen and estrogen to a woman in her mid-40s or mid-50s to treat various menopause-related discomforts like hot flashes, mood changes, irregular periods, night sweats, vaginal dryness, and many more. The number of recipients and popularity of the treatment peaked in the 1990s and remained the same until 2002 when the result of the first clinical trial of the treatment was published. The clinical trial report showed that HRT causes more damage to health than benefits. It means embracing HRT without scrutiny get sick willingly. This article will explore potential risks and benefits of HRT so that by reading this article women can make informed decisions.
Understanding Hormone Replacement Therapy
As the name implies hormone replacement therapy aka menopausal hormone therapy is the replacement of female sex hormones estrogen and progesterone that the human ovary cannot produce naturally. The components of estrogen and progesterone are used during the artificial hormone production.
There are different types of hormone replacement therapies are available. It may involve the administration of synthetic estrogen, progestogen, or both. In rare cases, some doctors may also prescribe testosterone. What type of HRT women will get depends on factors like the stage of menopause women are passing, whether they have a history of hysterectomy, and their personal choice when it comes to choosing an HRT type.
Prioritizing the recipients’ preferences and doctors’ decisions, the administration process of HRT varies accordingly. Female sex hormones can come in various forms including tablets, skin patches, vaginal rings, gels, sprays, creams, and pessaries.
The frequency of the administration of HRT also varies. Women may get HRT treatment regularly, sequentially, or cyclically.
Women may take hormone replacement therapy if they are suffering from menopause-related symptoms. The treatment may start before the onset of menopause and may extend to post-menopause. The age range of women who undergo the menopause process is 45 to 55. Some women may experience menopause before they become 45 years old.
Benefits of HRT
Relief from Menopausal Symptoms
As a woman draws to menopause. her ovary shrinks which results in the stoppage of the production of two female sex hormones -estrogen, and progesterone. Deficiency of these two hormones in women triggers menopausal discomforts. Administering synthetic estrogen, and progesterone to women suffering from menopausal side effects will offset hormone shortages and will alleviate their discomforts.
Administration of synthetic estrogen to women during menopause will also strengthen their bones and prevent osteoporosis. Human bones are constantly broken down inside. However, this breakup is restored with special bone cells. Bones breakup followed by the restoration process is called bone remodeling. During the menopause stage of women as the estrogen level drops, the bone remodeling process becomes imbalanced which results in more bone being broken than reformed which results in bone loss or osteoporosis. If hormone deficiency is compensated with artificial hormones, the bone remodeling process will not interrupted which translates to no osteoporosis.
As you get older and older, especially after the 60s, osteoporosis will happen naturally. However, in the years of menopause, hormone deficiency will accelerate the osteoporosis process to the extent that bones may become fragile and prone to fracture.
Hormone replacement therapy is also beneficial to cardiovascular health. Studies show that plaque development in heart arteries is less in women who receive HRT to relieve menopausal discomforts. Estrogen is also conducive to cholesterol and increases blood flow by widening the blood vessels.
It may sound unheard of to many women, but their overall quality of life is heavily dependent on their sexual life. Hormone replacement therapy is quite effective in addressing women’s different sexual-life-related problems. Women’s sexual life is badly impacted by the shortage of the sex hormone estrogen when they pass through menopause. Painful intercourse, low libido, mood changes, anxiety, and depression make their sexual, and the overall quality of life measurable. The administration of HRT will restore female sexual life and improve overall quality of life.
Risks and Side Effects of HRT
Short-term side effects
Except for over-the-counter drugs or OTC, no medication is completely free of side effects. HRT is no exception. However, not all patients experience the same level of side effects. Some patients experience minimal side effects while it could be harsh for others. Also, menopausal side effects and HRT side effects are similar. So HRT may not be the main culprit for causing discomfort. What type of HRT women receive determines the likelihood of the nature of the short-term side effects.
Side-Effects of Estrogen
- Headaches
- Breast pain or tenderness
- Feeling sick or nausea
- Unexpected vaginal bleeding or spotting
- Mood change
- Leg Cramps
- Mild rash or itching
Side Effects of Progestogen
- Changes in your periods
- Headaches
- Breast pain or tenderness
- Feeling tired or dizzy
- Nausea
- Diarrhea Also
Long Term Risks
HRT was considered a breakthrough in medical science- a great relief for aging women suffering from several gynecological diseases. However, a serious dent in HRT treatment occurred with the publication of a major trial. The trial report showed that HRT treatment is full of considerable risks with adverse side effects including breast cancer, heart disease, and pulmonary embolism. Among these adverse effects, breast cancer is the top concern. Breast cancer can happen to women who have a hysterectomy(removal of the womb). So estrogen alone is not responsible for breast cancer. The administration time of HRT is another factor. The chances of breast cancer are negligible for women who took HRT for one year or less. Risk increases significantly if the administration time is 5 years or more.
Controversies and Debate
Since science does not conclusively prove that HRT is fully safe or may cause adverse effects, the treatment turned out to be a matter of debate in the scientific community. Like other treatments, HRT also undergone several clinical trials since the 2000s. Published reports of these trials showed that scores of women experienced adverse effects after receiving HRT. The type of hormone used, the method of administration process, and the timing of the first administration- any of these three factors may cause adverse effects. The other potential reasons for the negative impacts of HRT are women’s BMI, family or personal history, and the personal experience of menopause. Since scientists cannot conclusively point out the real reason for adverse effects, controversy surrounding the treatment remains.
Women find themselves in a difficult situation when it comes to deciding on HRT. A health professional like a GP is a useful person to consult on HRT. With a GP, women can discuss at length the potential risks, and benefits of HRT, their specific condition, and any new development regarding the treatment. Decision on HRT requires research, consultation, and communication with other women.
