Is there a menopausal woman out there who has not been overwhelmed by the very words hormone replacement therapy? For years, hormone replacement therapy or HRT was considered the best way for women to deal with their menopausal symptoms. More recently, women and physicians have been questioning the need for HRT and seeking out possible alternatives. How can women wade through the massive amounts of information and the many contradictions? This article is the first in a series that will tackle the subject of HRT and provide a starting point for understanding this confusing topic.

What is hormone replacement therapy?
Hormone replacement therapy (HRT) is also called Estrogen Replacement Therapy. It is given to menopausal patients to help relieve the symptoms associated with lowered or fluctuating levels of estrogen hormones in the body. These symptoms are usually hot flashes, night sweats, mood swings, and interrupted sleep patterns. Many women also experience vulvar dryness and difficulty passing urine. Estrogen is used to offset the effects of these symptoms that for some women are severe enough to interfere with their daily lives.

Menopause can occur naturally over several years as the hormones react to the changes in the reproductive system. It can also be the result of a hysterectomy. If only the uterus is removed, menopause will still take place gradually. However if the ovaries are removed, the onset of menopause is sudden and immediate. Depending on how menopause occurs, doctors may prescribe one of two types of hormone replacement therapy; estrogen replacement therapy, or estrogen combined with progesterone (Progestin).

Estrogen replacement therapy
Estrogen is administered in low dosages in a pill form taken daily, but may also be taken by vulvar cream, skin patch, pessary ring, or six month implant. Regardless of which method is chosen, the estrogen is released into a woman’s body to help build up the estrogen levels. Women who have undergone a hysterectomy leading to immediate menopause are given estrogen alone.

Estrogen and progesterone therapy
These two items are given to women who are going through menopause naturally. Progesterone is usually taken in a pill form, but may also come in a skin patch, vulvar gel, or a Mirena Coil. A Mirena Coil is an intrauterine device inserted into the uterus and releases progesterone on a continual basis. The progesterone is used to reduce the risk of the estrogen causing the walls of the uterus to thicken too much. This overgrowth of cells in the uterus, known as hyperplasia, is thought to be connected to an increased risk of uterine cancer.

Hormone replacement therapy is a miracle for some, a nightmare for others, and a lot of confusion for everyone in between. Not all women will need to take hormone replacement therapy. Some women undergo minimal or no discomfort during menopause. For others, menopause is a time of immense physical symptoms. Deciding whether hormone replacement is right requires women to understand their menopause situation and talk to their healthcare professionals. More importantly, women can arm themselves with the information they need to help take charge of their menopausal years.

Menopause, Your Doctor, and You