Hormone replacement therapy (HRT) has been the topic of numerous conflicting reports over the past few decades. Some clinical trials suggest that HRT poses an increased risk of certain health conditions, while other studies demonstrate this therapy’s effectiveness in relieving symptoms associated with menopause and reducing the risk of diseases such as osteoporosis and heart disease. If you’re considering hormone replacement therapy, it’s important to understand the facts so that you can make an informed decision.
What is hormone replacement therapy?
Hormone replacement therapy is a treatment that supplements the body’s natural hormones in both men and women. Women who are experiencing menopause and women who have had a hysterectomy are typically good candidates for treatment.
HRT is used to treat symptoms associated with declining hormone levels, such as hot flashes, night sweats, fatigue, insomnia, vaginal dryness, weight gain, anxiety, moodiness, dry skin, and low sex drive. HRT uses estrogen and progesterone to help relieve these symptoms and guard against osteoporosis.
In women who have had a hysterectomy, estrogen therapy can be used by itself. Women who experience menopause naturally typically receive both estrogen and progesterone in order to continue the menstruation cycle and protect against uterine cancer.
The history of HRT
Hormone replacement therapy became available during the 1940s and started becoming more widely used during the 1960s. The popularity of HRT began declining after 2003 when studies revealed an association between HRT and an increased risk of breast cancer and heart disease. Many doctors stopped prescribing HRT around this time. The number of women who received HRT fell by 66 percent and has remained low ever since.
Since then, many health experts have pointed out several flaws in the original studies that led to the declining use of HRT. The women studied were in their mid-60s, which is older than the average age of menopause, which typically occurs between the ages of 45 and 55. Additionally, many women in the original studies were overweight and already at risk of certain health conditions.
Newer studies have shown no increased risk for heart disease when HRT is started within 10 years of beginning menopause. A 2012 study conducted in Denmark revealed that healthy women who started HRT immediately after menopause were able to benefit from a reduced risk of heart disease and a lower rate of death caused by heart disease.
Today, many doctors recommend hormone replacement therapy for women who are undergoing menopause. HRT is not recommended for women over the age of 60. However, women who start using HRT before the age of 60 do not have to stop this therapy upon turning 60.
Doctors generally view HRT as a safe, effective treatment when used to relieve menopause symptoms and when used at the lowest effective dose. Patients should keep seeing their general practitioners once every year for assessments and to determine whether they can benefit from continuing to use HRT.
How hormone replacement therapy works
As women become older, their hormone levels gradually decrease as part of the natural aging process. The natural decline in estrogen and progesterone can produce a range of unwanted symptoms that put women at risk of serious medical conditions and that compromise their well-being and quality of life.
HRT supplies women with a boost in these hormones so they can reduce their risk of serious diseases like osteoporosis and cancer, stave off symptoms of menopause, and get back to feeling more comfortable and enjoying their lives.
HRT can be delivered in the form of creams, gels, tablets, vaginal rings, skin patches, and pellets. Some forms of HRT, such as bioidentical hormone replacement therapy, can be personalized for women to ensure they receive the exact doses of estrogen and progesterone that their bodies need. This helps reduce the risk of health conditions associated with having high hormone levels — such as chronic fatigue, breast cancer, and endometrial cancer.
Are HRT pellets safe?
HRT pellets are placed just under the skin and consistently release small doses of hormones to prevent the “roller coaster” effect associated with many other types of hormone replacement therapy. HRT pellets deliver sustained hormone levels throughout the day for between 4 and 6 months, or until the pellets have been completely dissolved by the body. HRT pellets are generally used only in bioidentical hormone replacement therapy, since the hormones and pellets used are completely natural and can be safely absorbed by the body. HRT pellets are safe to use, and have been backed by nearly 8 decades of professional medical research.
Will hormone replacement therapy stop hot flashes?
Yes, HRT can help relieve hot flashes and many other symptoms of menopause. Hot flashes are thought to be triggered by declining estrogen levels. Lowered estrogen levels can interfere with the section of the brain that regulates body temperature — making it difficult for the body to lower and regulate body heat when necessary. As a result, women sweat and experience hot flashes as their bodies try to cool down. As women’s hormones stabilize with HRT, hot flashes may reduce in severity or go away completely.
Does hormone replacement therapy help with weight gain?
Yes, HRT can help prevent and reverse weight gain by regulating women’s estrogen levels. Estrogen plays a major role in metabolism, body weight, muscle mass, and insulin production. Falling estrogen levels can interfere with these factors to cause weight gain and difficulty with losing weight. However, women who use HRT can benefit from reduced belly fat, increased energy and metabolism, improved insulin sensitivity, and the ability to effectively maintain muscle mass — all of which can help prevent weight gain.
Does hormone replacement therapy help depression?
Yes, HRT may help women reduce and prevent depression. Fluctuating hormone levels during menopause can often lead to irritability, mood swings, and mental health disorders such as anxiety and depression. Unpleasant menopause symptoms like hot flashes, night sweats, vaginal dryness, and loss of sexual libido can also contribute to depression in women who are going through menopause. Hormone replacement therapy can help treat depression by regulating estrogen levels and improving many unwanted symptoms related to menopause.
Can HRT reverse skin aging?
HRT may help reverse signs of skin aging by regulating hormones responsible for managing inflammation, tissue repair, and cell growth. A decline in estrogen production can cause skin to lose its elasticity and become thinner, which can lead to sagging, fine lines, and wrinkles.
Some menopause symptoms like night sweats, insomnia, and anxiety can lead to loss of sleep and a decrease in the body’s production of melatonin — both of which are factors that also contribute to signs of aging. HRT can help women achieve a more youthful appearance by regulating hormones that commonly cause signs of aging.
Hormone replacement therapy for men
HRT is also available for men to treat symptoms of andropause — the male version of menopause, which marked by a drop in testosterone levels that many men experience as part of the natural aging process.
Benefits of HRT for men include increased energy, weight loss, improved mood and mental focus, decreased blood pressure and cholesterol, and improved muscle strength and sexual function.
Is hormone replacement therapy right for me?
HRT may be ideal for you if you suffer from moderate to severe symptoms of menopause that strongly impact your health, well-being, and quality of life. Hot flashes, weight gain, sleep loss, depression, and reduced sex drive are just some unpleasant symptoms of menopause that can be difficult to manage and live with, but that can be improved with hormone replacement therapy.
HRT is also ideal for those who have lost bone mass and aren’t responding to other treatments, and for those who have had a hysterectomy, have had their ovaries removed, or who have suffered loss of ovary function.
Though HRT offers a number of health benefits for women going through menopause, this treatment may not be ideal or safe for everyone. Talk to your doctor about the risks of HRT if you suffer from abnormal vaginal bleeding, have gallbladder disease, you’re a smoker, or if you have blood clots or chronic liver disease. HRT may not be safe for you if you have a family history of breast cancer, endometrial cancer, or uterine cancer.
Bio-identical HRT at Garcia Weight Loss and Wellness
Garcia Weight Loss and Wellness Centers offer a form of HRT that uses bioidentical hormones, which are hormones identical to those produced by the human body. Bioidentical hormones are shown to be more effective than synthetic hormones, and are associated with fewer unpleasant side effects. Contact us today to request a no-cost consultation and to learn more about how hormone replacement therapy can help you look and feel your best!
Medically reviewed by Jay J. Garcia, MD on November 28, 2018
This post was originally published in April, 2017, and has been updated for freshness, accuracy, and comprehensiveness.