Hormone Replacement Therapy (HRT) for Menopause
Hormone replacement therapy for menopause can involve any number of combinations of estrogen, progestogen and testosterone. Or simply, only one of estrogen and progestogen.
Though estrogen and progestogen are the main hormonal players during perimenopause, women still produce small quantities of testosterone. And sometimes synthetic estrogen replacement therapy causes testosterone levels to fall.
In this case, a doctor may prescribe a testosterone supplement to restore her levels to normal. One thing to be aware of in this case is that testosterone supplements can affect the liver and cholesterol levels. So it’s important to have regular liver function tests and lipid tests to make sure they remain in a normal range.
With the exception of the combined estrogen and progestogen pills, treatment doses and the ratio of hormones given will be very individually tailored. Women’s bodies are very unique, and the hormone replacement therapry for menopause that works for one will not necessarily work for another.
Some women get great relief from synthetic estrogen/progestogen hormone replacement therapy, others find their menopausal symptoms are worse. And still others cannot tolerate synthetic hormones, getting too many side effects.
One of the problems with the combined hormone replacement therapy is that only synthetic progestogen is used. And of course, the ratios are set by the manufacturers, not individually tailored to each woman’s symptoms and hormone levels.
Some women experience side effects on higher doses of estrogen as well. For this reason, estrogen hormones are now available in lower dose medications.
Both lower dose and regular dose estrogen hormone replacement therapy have benefits with:
- hot flushes
- bone density
- decreases the risk of heart disease, though the higher dose estrogen has a 20 to 30% greater protective effect
There are differences in the benefits of low dose and regular dose estrogen hormone replacement therapy, however. The regular dosage helps with these symptoms, but the low dose does not:
- vaginal dryness
- good for helping with painful sex
- the occurrence of vaginitis
- joint pain
- itchy skin
- skin’s collagen levels
- the production of sebum in the skin, and hence skin moisture
- waist to hip ratio
- lean body mass
- Estrogen replacements are available in patches, orally, creams, gels and as sepositaries. Vaginal estrogen is generally given when the symptoms of menopause are greater in the vagina and bladder.
There are a number of factors to take into consideration if you’re thinking of using hormone replacement therapy for menopause. How you tolerate synthetic hormones is obviously the first consideration. But the way the hormones are delivered to your body can have quite an impact on whether HRT will work also. Some women respond well to oral HRT, others find that their bodies don’t get enough of a dosage unless delivered through the skin in patches, creams or gels.
Be honest about how you’re feeling to your doctor. If you find you can’t talk to him, try another. Only through feedback can the dosage or type of delivery be changed, or testosterone added if needed.