Understanding hormone replacement therapy: what it is, why it's used, and how it's administered

When we reach menopause, the sexual glands stop producing certain hormones that don’t only signify the end of menstruation, but an entire system shift that takes its toll on the body. Hormone replacement therapy is a way to ease this transition so that it is less turbulent and uncomfortable. We spoke to a leading consultant obstetrician and gynaecologist in Kent, who told us all about hormone replacement therapy and its purpose.

What is hormone replacement therapy?

Hormone replacement therapy (HRT) is a way to reintroduce or resupply hormones that are at low levels in the body. It is commonly utilised as a treatment for menopause symptoms, but can also be used as part of transgender and gender-affirming healthcare as well as treatment for hypogonadism.

How does HRT help with menopause?

For women struggling with adverse symptoms of menopause, HRT can alleviate the worst of them by replenishing the diminished supplies of oestrogen and progesterone. Menopause begins around the age of 45 and will continue on average for seven years, marking the end of the reproductive ability of a woman. These hormones have an important function in a woman’s body that isn’t only related to her fertility status. The physical and mental symptoms illustrate how the body is affected when the levels of these hormones fall.

Symptoms of menopause that women may find challenging are:

• Hot flashes
• Vaginal dryness
• Mood swings
• Low libido
• Difficulty sleeping
• Anxiety and depression

HRT is able to address these symptoms, and is further beneficial for bone health. As oestrogen helps to maintain bone density, women in menopause are at risk of osteoporosis, thus HRT can help protect the bones and reduce the chances for fractures. Some research has suggested that HRT can lower the risk of coronary heart disease for older women as oestrogen manages cholesterol and increases blood flow.

How is HRT administered and what are the side effects?

HRT was originally prescribed as a pill, but nowadays it can be administered in many forms, such as:

• Dermal patches
• Gels
• Creams
• Intravenous injection
• Sprays
• Intrauterine systems (IUS), also known as the Mirena coil and doubles as contraception
• Pessaries and vaginal rings

The kind of HRT that each patient needs will vary on their bodies, previous medical history, and what works best for their lifestyle. Not all women who are undergoing menopause will be suitable to start HRT, such as those who have a history of breast, ovarian, or uterus cancer.

Furthermore, the endocrine system is delicate and long-term HRT use can increase the risk of breast cancer, stroke, other heart diseases, and blood clots, so it is recommended that patients take the lowest effective dose over the shortest possible duration in order to mitigate risk. People on HRT may also experiencing headaches, indigestion, swelling and sensitivity of the breasts, and bloating.

If you are considering HRT or struggling with menopause, book an appointment with a specialist via Top Doctors.