Hormone replacement therapy (HRT) is one of the most popular ways to treat menopause symptoms, including mood swings, night sweats, and hot flashes. HRT helps these symptoms by replacing the estrogen hormone that isn’t being produced as efficiently in your body during menopause as it was when you were younger. There are many different types of HRT; in order to determine which one might be best for you, you should consult with your doctor to find out more about the different options available to you.
5 Signs it’s Time to Consider Hormone Replacement Therapy For Menopause
For many women, hormone replacement therapy (HRT) provides relief from menopausal symptoms like hot flashes and night sweats. In fact, nearly all women experience these symptoms during menopause.
For others, estrogen helps with vaginal dryness, itching, and other uncomfortable symptoms. However, there are risks associated with taking ERT—especially if it’s taken over a long period of time or in higher doses than recommended.
To know if hormone replacement therapy is right for you, it’s essential to understand how it works and whether there are other viable treatment options.
Here are five signs that may indicate it’s time to discuss your symptoms with your doctor:
- Hot flashes or night sweats that disrupt sleep
Two out of three women experience hot flashes during menopause. While these can be uncomfortable, they usually subside on their own after two years.
For those who continue to have hot flashes or night sweats, however, hormone replacement therapy may provide relief from these symptoms after one year of use. Night sweats are less common than hot flashes but can still be disruptive during sleep because they cause frequent awakenings and excessive sweating at night.
If a woman wakes up drenched in sweat several times a week, hormone replacement therapy may help reduce nighttime sweating as well.
- Vaginal dryness
While vaginal dryness is more likely to occur in postmenopausal women due to low estrogen levels, many younger women complain of vaginal dryness as well—especially those without children who aren’t getting enough lubrication naturally through sexual intercourse. The good news? Although some studies suggest that hormone replacement therapy doesn’t improve vaginal dryness among postmenopausal women, some treatments such as topical creams containing estrogen could work just as well—and without any additional risks associated with ERT.
- Decreased libido
Even if hormone replacement therapy does improve vaginal dryness, not all women will notice an increase in their sex drive when taking hormones. Estrogen plays an important role in female arousal—but testosterone also affects libido.
Many women, regardless of age or hormonal status, find that a decline in libido begins long before they reach menopause and often has little to do with hormones alone (more on that below).
Unfortunately, hormone replacement therapy isn’t typically recommended for improving sexual function among healthy adults, so most physicians will focus instead on addressing potential causes outside of hormones (e.g., fatigue).
- Mood swings
Hormone replacement therapy can alleviate mood swings and irritability that sometimes accompany perimenopause and menopause. Research suggests high-dose ERT reduces depression rates by 50 percent within six months compared to placebo, making hormone replacement therapy a possible alternative treatment for premenstrual dysphoric disorder (PMDD) —which used to be known as premenstrual syndrome (PMS)
- Stress management
Other research shows hormone replacement therapy alleviates mood changes related to stress in perimenopausal women experiencing anxiety or panic attacks. In addition, evidence suggests that selective serotonin reuptake inhibitors (SSRIs)—an antidepressant class—are no more effective than hormone replacement therapy after six months of use.
That said, hormone replacement therapy offers no protection against memory loss and cognitive impairment that occurs as a result of normal aging, nor can it treat Alzheimer’s disease or dementia. But for women dealing with stress and anxiety in menopause, hormone replacement therapy may be a safer alternative to prescription antidepressants.
Side effects Contradictory results are emerging about the safety of hormone replacement therapy (ERT). A large study in 2002 found that women who take hormones had an increased risk of breast cancer and stroke compared to women who did not take hormones, while other studies revealed no increased risk of breast cancer.
Hormone replacement therapy may cause side effects. Notify your doctor if any of these symptoms are extreme or do not go away:
- upset stomach.
- stomach cramps or bloating.
- appetite and weight changes.
- changes in sex drive or ability.
4 Things That Happen When You Start ERT
Suddenly, hot flashes (the really annoying kind) will be a thing of your past. A side effect that comes with estrogen therapy is an increased risk of blood clots.
That’s because estrogen also acts as a blood thinner, allowing more room for clots to form in your bloodstream. This isn’t something to be overly concerned about—especially if you’re having hot flashes—but it’s something to pay attention to.
If you have concerns, speak with your doctor about alternatives like progesterone-only hormone replacement therapy. Unfortunately, most doctors say not to take HRT unless there are specific symptoms (like night sweats or bone loss) that warrant treatment.
Before taking HRT, make sure you’ve tried other treatments first; we recommend doing some research online and speaking with your doctor. Once you get approval from both parties, begin with low doses and work up from there to avoid any problems before they occur.
For example: Start out on 0.3 milligrams of bioidentical progesterone cream and gradually increase every few days until finding what works best for you (usually between 2–3 milligrams per day).
One popular method is two pills each morning followed by two pills at night; aim for 0.625 milligrams/per day while keeping in mind that stress levels can affect how much you’ll need to go by how your body feels overall rather than just dosage amounts listed on websites/in books. Another way is to use Lab Me’s crucial female hormone test which you can perform at-home and tests not only the crucial hormones involved in ERT but cortisol as well. Cortisol is a key player in monitoring your stress levels.
After roughly four weeks, lower your dose back down to where you were initially and stay here for several months before moving forward again. You may notice improvements within one month but often take around three months of consistent use before noticing a dramatic change in menopausal symptoms.
The good news is these symptoms don’t last forever!
You should see improvement anywhere from six months to one year after beginning HRT but almost always sees an end (at least temporarily) within three years. Typically, changes seen through estradiol therapy vary widely among women—which means there’s no right way of going about things when it comes to hormone replacement therapy!
Some may feel relief within several weeks while others might wait months depending on how severe their original menopausal symptoms were. But even if you feel nothing, continue using ERT for as long as your doctor recommends. There are many benefits to long-term HRT, such as a reduced risk of heart disease, improved memory function, and lower chances of developing Alzheimer’s Disease.
Studies have shown that those who take estrogen for 10 years gain longer life expectancy than those who do not; however, remember that reducing your risks doesn’t mean you’ll live longer – despite everything studies tell us – it only reduces your chances.
The positive effects of hormones can stop abruptly once you stop them altogether; because of how quickly they leave your system, it’s hard to determine whether or not they were actually effective without participating in long-term tests.
3 Major Side Effects of Hormone Replacement Therapy for Menopause
Side effects may occur while taking ERT and vary depending on your body’s response to hormone replacement therapy.
- Possible side effects of ERT include discomfort, including nausea, bloating, and fluid retention; migraine headaches; breast tenderness or swelling; and vaginal bleeding between periods.
If you experience any of these side effects contact your doctor immediately.
- Long-term use of ERT can increase a woman’s risk of stroke, heart attack, blood clots in the lungs (pulmonary embolism), irregular heartbeat (atrial fibrillation), and endometrial cancer.
- Unlike oral contraceptives that provide a daily dose of hormones at one time, there is no daily dosing with estrogen replacement therapy. Therefore, women who use estrogen must take a pill every day in order to receive its health benefits during menopause relief.
It’s also important to note that Estrogen should not be used as birth control and can make your periods heavier and more painful. Women using long-term estrogen replacement therapies may need periodic cervical smears if menstruation has stopped.
Monitoring progress should be the cornerstone of any hormone replacement. You can easily. take control of this into your own hands using Lab Me’s at-home hormone tests.
Major Contraindications To Hormone Replacement Therapy for Menopause
Women who are planning to become pregnant or are breastfeeding should not take hormone replacement therapy.
Patients taking anticoagulants, such as warfarin (Coumadin), may need to change their dosage while on HRT. Patients with breast cancer and women with a history of uterine cancer should avoid HRT because it can cause cancer to grow more quickly.
Women who have had strokes or blood clots in their legs should not take estrogen without first talking to their doctor. Women who have had strokes or blood clots in their legs should not take estrogen without first talking to their doctor. If you develop any unusual vaginal bleeding contact your doctor immediately.
You shouldn’t use menopausal hormone therapy if you:
- Are allergic to estrogens or progestins;
- Have had a serious pelvic infection after menopause;
- Have undiagnosed abnormal genital bleeding;
- Currently have, or have ever had, breast cancer;
- Have endometrial hyperplasia-the lining of your uterus is too thickened (this condition may lead to cancer);
- Are pregnant;
- Had a stroke, heart attack, or other cardiovascular diseases that wasn’t caused by high cholesterol levels within three months before starting hormones;
- Have ever experienced blood clots in your legs due to vascular disease unless you’re taking anti-clotting medicine.
The Health Benefits of ERT
It may be tempting to dismiss hormone replacement therapy (also known as HRT) as a treatment option, but it offers some substantial health benefits.
ERT increases bone density by preventing bone loss; it can also improve cardiovascular health, according to a 2011 review published in Menopause, a journal of The North American Menopause Society.
In addition, menopausal women who receive hormone replacement therapy have lower incidences of coronary heart disease and osteoporosis compared with women who don’t receive treatment. It’s important to note that not all women are good candidates for ERT. Women over 65 years old should discuss their options with their physician before taking ERT.
Additionally, ERT is recommended for postmenopausal women whose ovaries were surgically removed or destroyed due to cancer or benign tumors. Certain medications—including statins and warfarin—may interact with estrogen and increase certain risks associated with taking ERT. If you’re on one of these medications, talk to your doctor about whether HRT is right for you.
Otherwise, ask your doctor if he/she thinks you would benefit from receiving hormone replacement therapy during perimenopause or after menopause has begun. Your doctor might suggest beginning therapy early in perimenopause, so you’ll avoid entering into menopause without undergoing hormonal changes.
This might help prevent hot flashes and other symptoms that occur during menopause. Ask your doctor what type of ERT is best for you based on your body type, overall health status, and medical history. Not every hormone regimen works well for every woman – even though they are produced under exacting standards – so there’s no guarantee any, one pill will work well for everyone.