Menopause is a regular part of ageing for women and marks the end of their menstrual period, but it can be accompanied by various menopausal symptoms that can be challenging to get through. Some women may experience mild symptoms and manage them effectively, while others struggle significantly with adjusting to these symptoms. In such cases, hormone replacement therapy (HRT) may be invaluable in alleviating these symptoms for a better life.
On Perimenopause and Menopause
Perimenopause is the transitional period before menopause that typically begins around age 45 and will cause various fluctuations in your reproductive functions. After going through 12 consecutive months without a menstrual period, you will have officially entered menopause. Throughout both phases, your ovaries will gradually produce less reproductive hormones, oestrogen and progesterone, that regulate various processes, including your sexual and reproductive functions. This imbalance can cause disruptive symptoms like hot flashes, vaginal dryness, and more.
What is Hormone Replacement Therapy?
Sometimes known as menopausal hormone therapy, HRT aims to provide relief from symptoms of perimenopause and menopause. As its name implies, HRT replaces the hormones that are no longer produced by the ovaries to relieve menopausal symptoms.
Key studies, including one by the Women’s Health Initiative, have found that HRT is beneficial for providing relief to menopausal symptoms in women going through early menopause. Additional studies have also indicated that HRT should be started within 10 years of the onset of menopause to maximise its benefits. Women who are undergoing early menopause also stand to benefit from starting HRT early. HRT for women above the age of 60 is also possible, but treatment should be individualised to reduce the risks of adverse effects.
Types of Hormone Replacement Therapy
Your HRT will depend on what may work best for relieving your menopausal symptoms after your initial consultation.
Oestrogen Therapy
This therapy only provides oestrogen and is generally recommended for women who have undergone a hysterectomy, a surgical procedure to remove the uterus. Oestrogen therapy comes in many forms, including:
- Oral pills.
- Topical gels or creams.
- Vaginal tablets and creams.
Oestrogen can also help prevent bone loss, which can occur due to poor oestrogen levels in the body.
Tibolone Therapy
For post-menopausal women experiencing menopausal symptoms a year after their last period, or after undergoing a hysterectomy, tibolone may be recommended. This medication contains a synthetic hormone that the body breaks down to help alleviate menopausal symptoms. It may also be recommended if you cannot tolerate oestrogen therapy or other HRTs, or if you have endometriosis or fibroids and still require HRT.
What are the Benefits of Hormone Replacement Therapy?
The benefits of HRT can be significant, as it can provide welcome relief from menopausal symptoms such as:
- Hot flashes.
- Night sweats.
- Vaginal dryness.
- Mood swings.
- Sleeping difficulties.
- Brain fog.
HRT can also offer additional benefits, such as:
- Minimising the risk of osteoporosis or other forms of bone damage.
- Reduced risk of certain cancers, such as uterine cancer.
- Helps clear your mind of brain fog.
- Maintain vaginal health.
How Often Do You Need Hormone Replacement Therapy?
For most HRTs, you will need to apply or take your medication daily or as instructed by your doctor. You will typically start on the lowest dose possible for your safety. If you are going through early menopause, a higher dose may compensate for the lower hormone levels produced by the ovaries. Your doctor will adjust this amount based on your age and current health, among other factors.
Once you begin HRT, you may need to return to your doctor for regular follow-up checks to determine your current hormone levels and adjust your HRT plan if required.
Potential Side Effects of Hormone Replacement Therapy
You may experience side effects when you first start HRT, which may include:
- Nausea.
- Light vaginal bleeding (spotting).
- Bloating.
- Breast tenderness.
- Headaches.
- Mood changes.
If you do experience any troubling side effects, such as severe mood swings, or if mild side effects persist for a long time, immediately see your doctor. They may need to adjust your HRT plan and dosage to alleviate these side effects.
Potential Risks of Hormone Replacement Therapy
HRT may also present various risks factors, including your age when you start HRT, the amount of time since the onset of menopause, and your medical condition. Some of the potential risks of HRT may include:
- Blood clots in your leg (deep vein thrombosis) or lungs (pulmonary embolus).
- Heart disease.
- Stroke.
- Gallbladder disease.
- Certain cancers, such as breast and uterine cancer.
Some forms of HRT may have fewer risks than others, but that may also depend on various factors, such as your current health. You can also minimise these risks by starting HRT before age 60 or within 10 years of menopause, and implementing healthy lifestyle changes like regular exercise. Nevertheless, you should speak with your doctor in detail before deciding if HRT is for you.
Who Should Avoid Hormone Replacement Therapy?
HRT may not be safe for all women. You should avoid HRT if you have any of the following:
- A history of heart disease or other risk factors.
- A personal or family history of breast cancer or certain chronic conditions.
- Liver disease.
- Prior history of stroke or blood clots.
- Pregnant or soon-to-be-pregnant women.
- Abnormal vaginal bleeding.
- Allergies to oestrogen or progesterone.
Is Hormone Replacement Therapy a Long-term Treatment?
HRT is not meant to be a long-term treatment, given the associated risks it may pose to women. It should be managed effectively to relieve menopausal symptoms in the shortest time possible and at the lowest possible dose. As such, you should see your doctor during the appointed follow-up checks to determine if you need to continue with HRT.
Moreover, you should also adopt various healthy practices to help manage menopause symptoms over a longer period after your HRT ends.
- Including more calcium and vitamin D in your diet improves your health and reduces the risk of bone damage.
- Eat more fruits and vegetables to improve your health and reduce the risk of chronic conditions like heart disease.
- Minimise alcohol and caffeine consumption that can trigger menopausal symptoms.
- Exercising regularly can helps maintain a healthy weight and improves overall fitness.
- Stay hydrated at all times to alleviate menopausal symptoms like vaginal dryness.
- Take time to relax and manage your stress with enjoyable activities.
Start Your Journey with O&G The Women’s Specialist
You can still live a fruitful life even with menopause, and we at O&G The Women’s Medical Specialist are here to support your journey with a full range of menopausal care services dedicated to enhancing your well-being. Contact us today for more information.
