As a woman reaches menopause, typically round 50 years of age, her body produces less and less of the hormones oestrogen and progesterone. Hormone replacement therapy (HRT) is the use of synthetic oestrogen and progesterone (called progestin) to replace, as much as possible, a woman’s depleting hormone levels. Menopausal women who have had hysterectomies may be placed on an oestrogen regimen, while other women may be treated with a combination of progestin and oestrogen.
Decreased hormone levels may be reflected in a variety of ways, which, depending on the individual, may range from annoying but mild symptoms to severe discomfort, sleeplessness anxiety and depression. One of the most characteristic symptoms of menopause are the ‘hot flushes,’ experienced by about 60% of menopausal women. Hot flashes may be accompanied by sweating, flushing or heart palpitations.
During menopause, changes occur in the urinary tract and vagina, resulting in drier less elastic tissue, and unintentional release of urine during sneezing, coughing, exercise or laughter. Urinary tract infections may also occur more easily at this time.
There are both beneficial and potentially negative side effects to HRT which need to be considered. Your doctor will take several factors into account before prescribing, including your current state of health and family health history. On the positive side, HRT benefits include relief of some or all of the menopausal symptoms as discussed above as well as a number of health ‘fringe benefits’. HRT prevents and treats osteoporosis and may offer protection against certain forms of heart disease. HRT may also offer some protection against Alzheimer’s disease and diabetes.
Possible negatives which your doctor will explain include a very slight risk of stroke, heart attack and cancer. These vary depending on whether oestrogen alone or both hormones are taken. In some cases, the research results on which risk factors are based are inadequate or contradictory and the long-term history of HRT in women is not yet fully known. Your doctor’s advice will not only guide you into the possible prescription of HRT, but at regular check-ups, will also take into account new treatment options or risk warnings which should be considered.