Hormone Replacement Therapy : Before Or After Menopause?

Thinking about going for a Hormone Replacement Therapy? Here is all you need to know about it! As you get older and closer to menopause, the production of oestrogen and progesterone starts slowing down. Eventually, there is a complete cessation of these two main female hormones. As a result, these hormones are mainly responsible for the menstrual cycle. These hormones also affect different parts of your body, including bones, heart, and the vagina.

When you reach the menopause stage, you can replace the natural hormones with the versions prepared in the laboratories. The process is called Hormone Replacement Therapy or Hormone therapy. Before going for the HRT, it is important to understand both the positive and negative sides of it. Is it right for you? Should you think about HRT? Or you should avoid it? Here are the answers to all your questions.

What are the Advantages of Hormone Replacement Therapy?

The benefits are divided accordingly as there are two types of HRT. Low-dose Vaginal Preparations of oestrogen and Systemic Hormone Replacement Therapy.

Systemic Hormone Replacement Therapy:

Systemic oestrogen is available in the form of pills, skin patches, cream, gel, and spray. It is the most effective version of Hormone Replacement therapy.

  • It relieves you from night sweats and hot flashes.
  • The therapy helps in recovering from dryness, burning, itching, pain and discomfort during sexual intercourse.
  • HRT combined with oestrogen and progesterone reduces the risk of colon cancer.
  • The therapy even reduces the risk of heart diseases if taken before menopause.
  • It provides protection from osteoporosis.

Low-dose Vaginal Preparations of Oestrogen:

This HRT comes in the form of cream, tablet or ring. It is effective in reducing vaginal and urinary symptoms after menopause.

Low-dose vaginal preparations do not heal major menopausal problems like hot flashes, night sweats, and osteoporosis.

Risks Associated with Hormone Replacement Therapy:

According to the most extensive clinical test done on Hormone Replacement therapy till date, has shown side effects as well. A pill prepared with oestrogen and progesterone (Prempro) has increased the risk of some serious health conditions, including:

  • Blood clots
  • Breast Cancer
  • Stroke
  • Heart Diseases
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The risk may vary according to the age and the gap between menopause and the therapy.

For example, a woman who goes for HRT at the age of 60 or after (more than 10-20 years after menopause) is at higher risk of developing some serious health conditions. On the contrary, if a woman starts the therapy before 50 or 55 (within ten years of menopause), is at lower risk of having serious health issues.

The risks of the therapy may vary according to various factors. It depends on the type and dose of oestrogen, whether the oestrogen is given alone, or it is combined with progestin. Some other factors that may vary the extent of risk are cardiovascular disease, cancerous development in the vagina, breasts or any other organ, and family history, etc.

If you are planning to have Hormone Replacement therapy, you must keep all these risks in mind.

Who should consider Hormone Replacement Therapy?

Despite the associated side effects, hormone therapy is still one of the most effective treatment.

  • Women suffering from moderate to hot flashes or other vaginal symptoms.
  • Those who have lost the density and mass of the bones and can’t bear the joints pain even after the treatments.
  • Women suffering from premature cessation of periods (menopause before 40).
  • Those who are suffering from premature insufficiency of ovaries.

Who Should Avoid Hormone Replacement Therapy?

 Although there are mixed effects of Hormone therapy on the overall health, there are a few conditions in which the therapy should be avoided. Here are a few of them:

Women having or previously had these health problems should not go for hormonal therapy:

Hormone Replacement Therapy

  • Breast cancer
  • Endometrial cancer
  • Ovarian cancer
  • Blood clotting in the lungs or legs (varicose veins).
  • Heart problems including heartache, heart attack, cardiomyopathy, carditis, angina pectoris, myocardial infarction, etc.
  • Liver diseases like liver abscess, acute or chronic inflammation of the liver, liver carcinoma, etc.
  • Unexplained bleeding from the vagina.

If you face menopausal symptoms after 40, avoid hormone therapy. Menopause after 40 is normal. You can surely talk about it to your doctor to reduce the risk of significant problems of post-menopause. It includes osteoporosis, irregular blood pressure, diabetes, heart-related problems, weakness, etc. Make some positive changes to your lifestyle that will lead to a healthy life even after menopause. If you opt for Hormone therapy, how you can reduce the risk of its side effects?

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Discuss with your Doctor about the Strategies:

Find out the best suitable product and delivery method for you: Not every product or delivery method is suitable for everyone. You need to discuss with your doctor which products are suitable for you.

You can take oestrogen in different forms including gel, patch, pill, vaginal cream, pessary ring or slow-releasing suppository. If you are facing only the vaginal symptoms, low-dose oestrogen in the cream form is the most suitable option.

  • Reduce the amount of medication as much as you can.
  • Go for regular follow-up care.

Hence, follow a healthy lifestyle that should include proper diet, mild to moderate physical workouts, stress management, etc.

This is all about hormone replacement therapy. It depends on person to person who wants to opt it. Moreover, it depends on your health condition, the age you get into the menopause; your priorities post menopause and some other things. If you can reduce the menopausal symptoms with other methods like medications, lifestyle changes, etc., you should not opt for it. Always talk to an experienced doctor even if you are a hundred percent sure about your decision.


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