A physiological period of life for women that occurs around the age of 50. The body’s production of estrogen and progesterone decreases, which can lead to many symptoms that impair quality of life. The function of the ovaries gradually ceases, and the balance and synthesis of secreted hormones is disrupted.
Ovulation in the ovaries occurs less frequently or disappears completely, which means that the corpus luteum that produces progesterone is no longer formed, which reduces its level in the body. Estrogens are still produced, which leads to a relative excess of estrogen. The consequence of the process is an irregular menstrual cycle and dysfunctional bleeding. The symptoms of early menopause often begin in premenopause:
- Tides
- Sweating
- Heartbeat
- Headaches
- Dizziness
- Tinnitus
- Chills
- Bloating
- Changes in blood pressure
On average, 3-5 years after the onset of menopause, intermediate symptoms include urogenital disorders:
- Vaginal Dryness
- Itching
- Painful intercourse
- Vaginal prolapse
- Frequent and painful urination
- Recurrent urinary tract infections
- Urinary incontinence
Hormone replacement therapy
Hormone replacement therapy (HRT) is the use of hormonal drugs to restore the correct balance of hormones in the body. The effectiveness of this treatment method has been proven over the years, but patients in our country are in no hurry to take the hormonal drugs prescribed by the doctor, because they are afraid of gaining weight.
In fact, all the horror stories of hormone therapy discussed online, such as the appearance of excess weight and the development of cancer, are myths.
The goal of hormone replacement therapy is to compensate for decreased ovarian function due to a deficiency of sex hormones by using optimal doses of analogues, which in turn improves the general condition of the patient and metabolic disorders that may occur in postmenopause.
Obstetrician-gynecologist prescribes therapy only after a comprehensive examination and assessment of the woman’s condition, namely:
- Ultrasound of the pelvic organs;
- Cervical cytology to rule out cancer;
- Assessment of risks of breast cancer, cardiovascular diseases, and thromboembolic complications;
- Mammography;
- Determination of cholesterol levels and its fractions.
📝 Please note:
With the right treatment, hormone replacement therapy reduces the effects of menopause: reduces the risk of developing many diseases that progress with a deficiency of sex hormones; improves the well-being of patients; “slows down” the aging of the body
Hormone Replacement Therapy: Myths and Reality
To better understand hormone replacement therapy or HRT, you need to understand what menopause is and why this painful period occurs in every woman’s life.
A decrease in the production of sex hormones such as estrogen increases the likelihood of menopause and, therefore, the need for hormone replacement therapy. Many women associate the onset of this stage with the end of menstrual function, but in fact, symptoms appear much earlier.
Before sexual dysfunction, itching and dryness in the vagina appear, pay attention to the primary symptoms: decreased mood, shortness of breath, increased sweating, a feeling of anxiety and restlessness, headaches, a feeling of hot flashes in the head and neck. A timely visit to a gynecologist at the Diet Doctor Kent clinic at the onset of menopause will help you reduce the manifestation of classic symptoms of menopause. But unfortunately, most women ignore the signals of their body and face serious problems.
Ways to combat menopause symptoms
The easiest and most cost-effective way is a healthy lifestyle. But this method is effective only in the early stages and rather delays, rather than completely prevents, the onset of menopause.
Treatment with all kinds of non-hormonal means – this approach shows effectiveness, but does not combat the root cause of menopause, namely, the decrease in sex hormones.
Hormone replacement therapy is the most effective and correct way to fight menopause. Unfortunately, hormone replacement therapy is associated with many myths and prejudices. Let’s try to figure out where the truth is and where the lie is.
Myth #1: Drugs are addictive
One of the most common misconceptions is about the supposed addiction to a drug containing estrogen hormones. Drugs in this category do not cause addiction or habituation, they only restore the patient’s hormonal balance.
Myth #2: Unnatural treatment method
This is a completely false misconception. The estrogens used in hormone replacement therapy are identical to the estrogens produced in a woman’s ovaries.
Myth #3: Estrogens make moustaches and beards grow
Estrogen is a female hormone, it helps maintain femininity. It is the lack of the required amount of estrogen in a woman’s body that causes increased hair growth, including on the chin and above the upper lip.
The Truth: As you can see, hormone replacement therapy is a completely safe and, most importantly, effective way to delay the onset of menopause.
Ready to Take Control of Your Hormonal Health?
Types Of Hormone Replacement Therapy
There are 2 hormone replacement therapy regimens:
Without treatment, menopausal symptoms can last for several years, significantly affecting a woman’s quality of life. Hormone replacement therapy is available as estrogen alone or as estrogen plus progestogen.
Synthetic hormones come in a variety of forms: creams, pessaries, tablets, and patches. Some are used every day, while others may only be used for a few days or once or twice a week.
For example, vaginal estrogen comes as a cream or pessary that is inserted into the vagina. It is used to relieve menopausal symptoms of the bladder and vagina, such as dryness, burning, or itching. It only works locally and is suitable for most women.
When using HRT, it is important to use the lowest dose of hormones that will relieve symptoms. It is recommended that treatment be reviewed at least once a year to see whether to continue it or not.
⭐ 1. Short-term
Aimed at stopping hot flashes, normalizing the emotional state, preventing urinary incontinence. The doctor prescribes the drugs for 2 to 6 months, and if necessary, repeats the course.
⭐ 2. Long-term
Lasts 8-10 years or longer. This regimen is best at preventing late manifestations, including cardiovascular disease, osteoporosis, and Alzheimer’s disease. There are no restrictions on the duration of HRT, but this only applies to those women who undergo regular examinations and tests. The upper age limit of therapy is 70-72 years, but subject to timely and continuous treatment.
Individualized Approach to Hormone Therapy in Menopause Management
Hormone therapy is part of a treatment strategy that includes a healthy lifestyle and correction of existing pathologies. When selecting a treatment option, the gynecologist prescribes the minimum dose of hormones to relieve symptoms. The doctor reviews the treatment plan annually and adjusts it if necessary.
Prescription of drugs is strictly based on indications and symptoms. Not only the stage of menopause, but also the time of its onset. For early menopause, up to 40 years, treatment continues until the woman reaches the average age up to 50 years, as maintenance therapy with osteoporosis prevention.
Individual patient characteristics are considered to: duration and quality of menstruation, gynecological surgeries, history of endometriosis, presence or absence of the uterus, ovary, tumors. So, it is necessary to constantly monitor the patient’s condition, health indicators according to tests, and correction of prescriptions.
Duration of HRT therapy
Women who decide to undergo hormone therapy need to understand that it is not a couple of days or even a month. Only long-term and systematic use of drugs will provide the necessary therapeutic effect, help the female body adapt to hormonal changes and painlessly move to a new stage of life.
HRT copes with early manifestations of menopause almost in the first days, but only long-term systemic use can consolidate the therapeutic effect and stop delayed manifestations of menopause.
tests before starting hormone therapy
A woman must take tests and undergo examinations on specialized medical equipment, only after that the doctor will be able to prescribe competent treatment. Here is a list of mandatory procedures:
- Densitometry;
- Ultrasound of the pelvic organs;
- Coagulogram;
- Clinical blood test;
- Endocrinologist examination;
- General urine analysis ;
- Consultation with a mammologist;
- Smears for oncology.
In some cases, other diagnostic data may be required: blood lipid profile, heart rate and blood pressure readings.
Benefits of hormone Replacement Therapy
For many women during menopause, the benefits of hormone replacement therapy outweigh the possible risks. So, the benefits of hormone replacement therapy include:
🌀 1. Reduction of vasomotor symptoms
Patients usually feel improvement within four weeks of starting treatment, with the maximum effect being achieved after three months.
The studies showed a significant average reduction in hot flash frequency, and severity by 87% compared to placebo.
🌟 2. Improving quality of life
HRT can also normalize sleep, eliminate muscle pain, which affects the overall feeling of life.
💠 3. Smoothing out mood swings
Also, the use of hormonal drugs helps to cope with the symptoms of depression.
🚻 4. Reduction of urogenital symptoms
Various studies have shown that HRT significantly reduces vaginal dryness and improves sexual function. Hormonal therapy can also relieve symptoms of frequent urination, as it has a proliferative effect on the bladder and urethral epithelium.
🦴 5. Reduce the risk of osteoporosis
Estrogens are the most effective way to increase bone mineral density and prevent osteoporotic fractures in women.
HRT is the first-line treatment for the prevention and treatment of osteoporosis in women with menopausal symptoms under age 50. Even low doses of oestrogen protect bones.
❤️ 6. Reduced risk of cardiovascular disease
The link between HRT and cardiovascular disease is controversial. However, taking synthetic hormones has been shown to reduce the incidence of coronary heart disease by about 50% if started within ten years of menopause.
🧬 7. Reduce risk of colorectal cancer
The Women’s Health Initiative (WHI) study found that the risk of colorectal cancer was lower in women taking combined conjugated equine estrogens and medroxyprogesterone acetate. Other studies have shown a reduced risk of colorectal cancer with oral combination HRT.
Side effects of hormone replacement therapy
All medications have side effects, even vitamins, if the dosage is not followed. Hormones also have them, although the benefits of HRT are many times greater than the possible side effects: Hormone replacement therapy can cause breast tenderness, fluid retention, mood changes, menstrual spotting and bleeding.
If you experience any of these side effects, talk to your doctor as your dose may need to be adjusted. Contact your doctor immediately if you experience any of the following symptoms while taking HRT:
🤕 1. Headaches and Migraines:
Hormonal changes can trigger or worsen headaches, especially when starting therapy.
🤢 2. Nausea:
Some people experience an upset stomach as their body adjusts to new hormone levels.
💧 3. Bloating and Fluid Retention:
HRT may cause the body to retain fluids, leading to bloating, particularly in the abdomen and legs.
🩺 4. Breast Tenderness or Enlargement:
Hormone fluctuations can make breast tissue feel sore, swollen, or sensitive.
😟 5. Mood Changes or Depression:
Emotional instability, anxiety, or depression can occur as hormones impact brain chemistry.
🩸 6. Vaginal Spotting or Breakthrough Bleeding:
Especially common in the early stages of therapy, similar to irregular periods.
⚖️ 7. Weight Gain:
Some individuals notice an increase in body weight due to hormonal shifts and water retention.
🩻 8. Blood Clot Risk:
Estrogen therapy can increase the likelihood of deep vein thrombosis or pulmonary embolism.
❤️🩹 9. Increased Risk of Stroke or Heart Disease:
Especially with long-term use or in people who start HRT later in life.
🎗️ 10. Higher Risk of Certain Cancers:
Some types of HRT (especially combined estrogen-progestin therapy) may raise the risk of breast, ovarian, or uterine cancers.
🧴 11. Skin Changes:
Some people may experience acne, pigmentation changes, or rash-like symptoms due to hormone shifts.
🫙 12. Gallbladder Issues:
HRT has been linked to an increased risk of gallstones and gallbladder disease.
Control of Your Menopause Journey Today
Contraindications to the use of HRT
Hormonal therapy can improve the patient’s condition without harming her health, but not all categories of women can be prescribed hormones to treat menopause. Hormonal drugs are contraindicated in:
- Acute thrombophlebitis
- Severe forms of diabetes
- Uterine and ovarian tumors
- Thromboembolic disorders
- Uterine bleeding of unknown origin
- Renal failure, and others.
Contact Southwest Arlington Medical Clinic in Pantego and Arlington, TX for detailed consultations and prescription of hormone replacement therapy
Who needs hormone therapy?
Among all women in the climacteric period, patients with moderate and severe manifestations of vasomotor symptoms most often need help, which significantly worsens the usual rhythm of life and sleep disturbances. So, what are the indications and contraindications? The main indications for hormone replacement therapy are:
✔️ Premature ovarian failure before age 40, due to ovarian surgery, chemotherapy, chromosomal abnormalities or other causes, as well as early menopause before age 45, since women are at high risk of developing cardiovascular diseases, affective disorders and dementia, as well as osteoporosis and fractures.
✔️ Presence of vasomotor symptoms (sweating and hot flashes), mood swings, sleep problems.
✔️ Genitourinary syndrome, such as dryness and discomfort of the vagina, overactive bladder.
❗️ IMPORTANT: local estrogens can also be used to treat genitourinary syndrome, which also has its advantages if there are contraindications to the use of systemic menopausal therapy. Menopausal hormone therapy has its contraindications, namely:
🔸 Suspected or previously diagnosed breast cancer, endometrial cancer, meningioma.
🔸 Vaginal bleeding of unknown origin, as well as untreated endometrial hyperplasia.
🔸 Current or past history of deep vein thrombosis or pulmonary embolism, angina pectoris, myocardial infarction.
🔸 Acute liver diseases, as well as those suffered in the past without normalization of its function indicators.
🔸 Hypersensitivity to the active substances or to any of the excipients of the drug.
🔸 Porphyria.
You should note that there are also relative contraindications, namely cholelithiasis, uterine leiomyoma, endometriosis, epilepsy, migraine. Having assessed all the risks, a joint decision is made on the possibility of taking hormone replacement therapy during menopause.
Southwest Arlington Medical Clinic: Personalized Hormone Therapy for a Healthier Menopause
Menopause and climax are special periods in the life of every woman, marking the fading of reproductive function. By the age of 45-55, the level of female sex hormones inevitably decreases. This leads to a deterioration in well-being and disruption of almost all organs and systems, because estrogens are responsible for dozens of processes.
Unfortunately, in most countries, the problem of menopause is underestimated. Women are reluctant to talk about menopause even with their relatives, not wanting to hear about old age. It is not the end, but only a step that can be overcome in order to continue to live a full, active life. Hormone replacement therapy or HRT helps ease this difficult period.
At Southwest Arlington Medical Clinic, you can undergo hormone replacement therapy HRT using individually selected drugs. Our gynecologists are not able to stop time. But they can make sure that at 50 and 60 years old you feel good and enjoy every day of your life.
We create HRT schemes after a comprehensive examination, prescribing drugs strictly according to indications, in therapeutically justified dosages that provide the required effect without side effects. We always carry out treatment under strict medical supervision.
Diagnostics before HRT therapy our clinic uses only proven certified drugs. The selection of HRT is based on diagnostics. We asses the condition of the lungs, cardiovascular, digestive, and endocrine systems during examination. The following studies are mandatory:
- Ultrasound of the pelvic organs;
- Mammography;
- Hormone tests;
- General clinical analysis of urine and blood;
- Biochemistry;
- Blood clotting test;
- Blood lipid profile;
- Extended colposcopy and colpocytological examination;
- ECG and X-ray;
- Ultrasound of the veins of the lower extremities.
We follow international standards for prescribing hormone replacement therapy (HRT), which are based on the results of clinical studies. The drugs and routes of administration are selected by a gynecologist and endocrinologist individually by considering the characteristics of each woman.
The physician performs a detailed gynecological examination, calculates the vaginal health index and epithelial maturation index, and measures the pH of the vaginal contents. They prescribe HRT only based on this data.
Brittle bones, heart problems, constant hot flashes, urinary incontinence, weakness – many women consider these manifestations to be natural, inevitable consequences of aging. This is not true. Properly selected hormone replacement therapy (HRT) will help to avoid serious complications and improve the quality of life.
Final words
There is nothing good in life without its downsides, and we can say that bioidentical hormone replacement therapy has amazing benefits, but it also has side effects. To get the most out of bioidentical hormone replacement therapy and avoid adverse side effects, do so with the help of experts in the field.
Frequently asked questions (FAQs) about hormone replacement therapy
Is it possible to get pregnant while taking HRT?
If HRT is prescribed in premenopause, when a woman still has her menstrual cycle and some eggs, then pregnancy is possible. If HRT is used in postmenopause, then pregnancy cannot occur.
What are the dangers of bioidentical hormones?
These days, bioidentical hormones are becoming increasingly popular among women as an alternative to hormone replacement therapy. And while bioidentical hormones have many benefits, such as a very low risk of cancer, they also come with some serious risks.
The danger with bioidentical hormones is that these hormones are man-made. This means that they are not found in nature and do not contain all the nutrients our body needs. So, by taking them, you risk a number of side effects, including bloating, spotting, weight gain, and even blood clots.
What is the difference between HRT and bioidentical hormones?
Hormone replacement therapy (HRT) differs from bioidentical hormones in that HRT involves the use of estrogen and progesterone to replace those that are missing or have decreased with age, illness, childbirth, and menopause.
It is often used in women who do not want to undergo a hysterectomy, while bioidentical hormones are naturally occurring, synthetic estrogens derived from plant and animal sources that are identical to or as close as possible to human oestrogen. They offer many of the same benefits as HRT, but without the associated risks.
Is Bioidentical Hormone Replacement Therapy Safe?
The Food and Drug Administration (FDA) and other health organizations have found no evidence that hormones marketed as “bioidentical” or “natural” hormones are safer than hormones used in traditional hormone therapy. There is also no evidence that they are more effective.
How long can you stay on bioidentical hormones?
The recommended duration of therapy is a maximum of seven years. However, you should stop the treatment when symptoms disappear. Although in some patients, symptoms may return, which may require other treatment options.
What are the signs that you need hormone replacement therapy?
HRT, or hormone replacement therapy, has many benefits for women experiencing menopausal symptoms and is a proven treatment option that helps relieve many uncomfortable symptoms.
There are many signs that indicate you may need replacement therapy. The most common symptoms that indicate you may need HRT are:
- Hot flashes and night sweats;
- Mood swings, irritability, or depression;;
- Sleep disturbances or insomnia;
- Vaginal dryness or discomfort during intercourse;
- Decreased libido or sexual dysfunction;
- Fatigue or low energy levels;
- Irregular or absent menstrual periods;
- Memory lapses or difficulty concentrating (“brain fog”);
- Dry skin, thinning hair, or brittle nails;
- Loss of bone density or increased risk of osteoporosis;
- Weight gain, especially around the abdomen.
However, your physicians are required to provide post-operative care procedures aimed at minimizing and controlling side effects.
Here at Southwest Arlington Medical Clinic in Arlington and Pantego, TX, our qualified doctors in collaboration with experts in bioidentical hormone replacement therapy will conduct a proper test to determine your condition and tailor the therapy to your unique needs.
We will find out if you have any co-morbidities to prevent any treatment conflicts that may lead to side effects. We will also provide periodic follow-up treatments to minimize and eliminate any side effects to a minimum.