Hormone Replacement Therapy

... Also called: ERT, Estrogen replacement therapy, HRT, Menopausal hormone therapy

What is hormone replacement therapy (HRT)?

HRT, sometimes called estrogent replacement therapy or ERT, refers to a woman taking supplements of hormones such as estrogen alone or estrogen with another hormone called progesterone (progestin in its synthetic form). HRT replaces hormones that a woman’s body should be making or used to make...

Menopause

Menopause is the time in a woman's life when her period stops. It is a normal part of aging. In the years before and during menopause, the levels of female hormones can go up and down. This can cause symptoms such as hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT) to relieve these symptoms. HRT may also protect against osteoporosis.

However, HRT also has risks. It can increase your risk of breast cancer, heart disease and stroke. Certain types of HRT have a higher risk, and each woman's own risks can vary depending upon her health history and lifestyle. You and your health care provider need to discuss the risks and benefits for you. If you do decide to take HRT, it should be the lowest dose that helps and for the shortest time needed. Taking hormones should be re-evaluated every six months.

Why would a woman take HRT?

Estrogen and progesterone normally regulate a woman’s menstrual cycle and reproductive health.  Estrogen is also important for bone health.

1. Women going through menopause and who had already gone through it (called post-menopausal)—The natural levels of these hormones drop during menopause. This drop can lead to symptoms such as hot flashes, night sweats, vaginal dryness, and sleep disturbances.  HRT may be used to help lessen some of these symptoms
2. Women with certain health conditions—In some cases, women’s bodies don’t make normal levels of the hormones because of a medical problems, such as premature ovarian failure.  For these women, HRT replaces the hormones that their bodies should be making.

What are the risks of HRT?

The risks of HRT differ depending on the health status of the woman taking it, and on the type of HRT.
Risks for healthy menopausal and post-menopausal women. The NIH conducted the Women's Health Initiative (WHI) trial to learn about the risks and benefits of continuous estrogen+progestin HRT for post-menopausal women. 

1. In one arm of this trial, researchers found that healthy post-menopausal women who took the therapy were at increased risk of invasive breast cancer, coronary heart disease, stroke, and blood clots. There were also benefits of estrogen plus progestin, including fewer cases of hip fractures and colon cancer.
2. Because the harm of HRT for healthy post-menopausal women in this trial was greater than the benefit, the researchers stopped the trial.
3. In light of the findings, the U.S. Food and Drug Administration noted that even though HRT effectively lessened some menopause symptoms in healthy post-menopausal women, it carried serious risks.  Women should discuss the potential benefits and risks of HRT with their health care provider.  The FDA recommends HRT for post-menopausal women be at the lowest doses for the shortest amount of time to reach treatment goals.
4. For more information about the WHI and its findings on post-menopausal contact us.

What is hormone replacement therapy (HRT)?

Risks of HRT for pre-menopausal women with certain health conditions Women whose bodies have stopped making estrogen or don’t make enough estrogen often take HRT to reduce symptoms and maintain overall health.

1. For instance, low estrogen levels in women with premature ovarian failure put these women at risk for osteoporosis and heart disease.  HRT helps maintain bone health and reduce the risk of heart disease.
2. In these cases, HRT is actually replacing hormones that the women’s bodies should be making—hormones that they need for their overall health. 
3. HRT taken by women with certain health conditions is different than that taken my post-menopausal women.  The risks associated with post-menopausal HRT do not apply to pre-menopausal women taking HRT.