Hormone Replacement Therapy

Introduction

Menopause is a physiological change that occurs in women around the age of 51. Hormone replacement therapy (HRT) combines oestrogen with a progestogen to protect the endometrium in women who still have their uterus. Hormone replacement therapy (HRT) is a menopause treatment that relieves symptoms. As you approach menopause, it replaces hormones that are at a lower level.

Types of hormone replacement therapy

Hormone replacement therapy (HRT) - most women take a combination of oestrogen and progestogen, and oestrogen alone. Oral, intravaginal, or transdermal oestrogen (oestradiol, oestradiol 17, oestrone, or conjugated equine oestrogen) The progestogen can be taken orally, applied topically, or administered through an intrauterine device . Oestrogen is used daily in HRT regimens, with progestogen added sequentially (cyclic regimen) or daily (continuous combined regimen) as needed. Tibolone is a synthetic steroid that has oestrogenic, androgenic, and progestogenic effects and can be taken as HRT. HRT can be supplemented with testosterone.

• Progestins
• Tibolone
• Testosterone
• Dehydroepiandrosterone
• Custom Compounding

Indications of hormone replacement therapy

The presence of bothersome vasomotor symptoms is the main indication for HRT. Vasomotor symptoms are common during the menopause transition and affect about 80% of women and are severe in about 20% of these women. The duration of these symptoms varies, with a median of four years, but may continue for as many as 12 years in about 10% of women. HRT may be indicated when menopausal symptoms are adversely affecting quality of life.

vasomotor symptoms

• hot flushes

• nightsweats,
• with or without awakening

Benefits of hormone replacement therapy

1. Menopausal symptoms: HRT is widely used for the established indications of menopausal symptoms.
2. Osteoporotic fractures: An older population with severe osteoporosis might have enjoyed greater protection from fractures with HRT. Some studies also found out the uses HRT reduces vertebral and hip fractures.
3. Cardiovascular disease: HRT is used high cholesterol levels and for coronary heart disease. Hence, for primary prevention of cardiovascular disease.
4. Healthy living: Women who use HRT have a significantly decreased risk of disease and death than women who do not.
5. Breast cancer: The risk of metastases among breast cancer patients who had used HRT was significantly decreased; this suggests that these cancers were localized to the breast and potentially had a better prognosis.
6. Colorectal cancer: studies suggested that estrogen reduces the risk of colorectal cancer. While other studies found out that HRT bring about protection of colorectal cancer with increased in duration of use.
7. Brain: some studies have found out that may have effect on the brain. A beneficial effect on verbal memory, vigilance, motor speed, and reasoning on symptomatic women.

Harms of hormone replacement therapy.

Harms of HRT include coronary heart disease, stroke, and thromboembolism (especially during early use). The risk of breast cancer and cholecystitis increases with longer use.