HRT always creates discussions but what are the facts?
11 January 2011
HRT stands for Hormone Replacement Therapy.
It is a replacement or substitute for the two female hormones usually produced by the body during a woman's reproductive years. These hormones are oestrogen and progesterone.1. To relieve menopausal symptoms
2. To prevent osteoporosis
What are the symptoms of menopause?
Some women do not experience any symptom at all, but many others experience one or more of the following symptoms:
hot flushes
aches and pains in muscles and joints
night sweats and disturbed sleep
problems with bladder
mood changes
dry vagina and discomfort during penetrative sex
problems with concentration and memory
Osteoporosis
Oestrogen is helpful in keeping calcium in the body and this is necessary for healthy bones. Osteoporosis is a condition in which the bones become brittle and thin, and are more likely to fracture. HRT can help to prevent bone loss, but obviously only whilst it is being taken. It can't repair damage done by osteoporosis but it prevents the condition from becoming worse.
What are the possible risks of HRT?
Short term HRT use is very safe, long term use may be associated with the following risks:
1. Breast cancer; combined HRT (containing both oestrogen and progestogen) is associated with a slightly increased risk of developing breast cancer. It is recommended that regular breast checks and mammograms should be considered for those who wish to continue HRT for more than 5 years. However, oestrogen only HRT does not appear to increase breast cancer risk.
2. Deep vein thrombosis; most HRT preparations are associated with a slight increase in risk of deep vein thrombosis.
3. Gall bladder disease; it is more common in long term users of HRT.
4. Fibroids: they may grow in size in response to oestrogen stimulation.
Blood pressure; very rarely HRT may increase blood pressure.
What are the side effects of HRT?
1. If you take the conventional preparation you will experience monthly withdrawal bleeds, however, if your menopause is more than three years ago, you may be suitable for a "no-bleed" preparation.
2. If you previously suffered from premenstrual tension ie prior to the menopause, this might return to some extent.
3. Fluid retention, nausea and vomiting which are often transient.
Breast tenderness
5. Weight gain; it is debatable whether or not HRT produces weight gain. Many women who are not taking HRT put weight on anyway after the menopause because their metabolism slows down.
How do I take HRT?
1. Tablets - this is the commonest form of HRT. Over 70% of women on HRT are taking tablets.
2. Patches - they are made of thin, see through material, often applied on to the buttock. The hormone is absorbed through the skin. The patches are waterproof so you can bathe and still go swimming with one on. With most preparations you only need to change the patch twice a week.
3. Hormone implant - this is less used nowadays as it involves local anaesthetic and a small cut in the abdomen. Nowadays implants are mostly reserved for those who require testosterone replacement to improve libido and tiredness.
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