What is Hormone Replacement Therapy?
Hormone Replacement Therapy (HRT) is a treatment administered to relieve the symptoms of menopause experienced by women. It replaces female sex hormones, oestrogen and progesterone, whose levels begin to drop as women approach menopause, allowing the body to function normally again.
Menopause is a condition when a woman’s ovaries stop producing an egg every month, whereby she will no longer have monthly periods or be able to conceive naturally. It usually occurs when women are in their 50s, but for few it could be earlier. Oestrogen and progesterone play an important role in a woman’s body; falling levels can cause a range of physical and emotional symptoms.
Oestrogen helps to release eggs from the ovaries, regulates a woman’s periods and helps in conceiving. It also controls other functions such as bone density, skin temperatures etc. While Progesterone prepares the womb for pregnancy and helps protect the lining of the womb known as endometrium.
In HRT oestrogen is used in combination with progesterone.
Most women will experience symptoms around menopause. Their duration and severity varies from woman to woman. Symptoms usually start a few months or years before your periods stop completely, and sometimes persist afterwards as well.
The first sign of menopause is usually a change in the normal pattern of your periods. You may start having unusually light or heavy periods and the frequency changes as well.
Common symptoms associated with menopuase include;
- Hot flushes
- Night sweats
- Vaginal dryness
- Difficulty sleeping
- Loss of sex drive
- Problems with memory
- Mood changes
- Stress incontinence – leaking urine when you cough or sneeze
- Bone thinning
- Reduced muscle mass
- Recurrent UTIs such as cystitis.
Most of these symptoms pass within two to five years.
Menopause is caused by a change in the balance of the female body’s sex hormones, which occurs as you get older. It happens when your ovaries stop producing as much of oestrogen and no longer releases an egg each month. As a result of these hormonal changes, many woman undergo physical and emotions changes.
Sometimes menopause can also be caused due to a treatment such as surgery to remove the ovaries (hysterectomy), breast cancer treatment, radiotherapy or due to other underlying conditions such as Down’s Syndrome or Addison’s Disease.
Signs and symptoms of menopause are usually enough to indicate for most women that they have begun the transition into menopause. Further evaluation can be done with your GP.
Tests may be ordered to confirm the diagnosis.
Follicle Stimulating Hormone (FSH) and Oestradiol A blood test measures the level of FSH and oestradiol in the blood. FSH increases and oestradiol decreases as menopause occurs.
Thyroid Stimulating Hormone To check for an underactive thyroid, which can cause symptoms similar to that of menopause.
You can start on HRT as soon as you begin to experience menopausal symptoms, once advised by your GP, however it is not suitable for people with a history of breast cancer, ovarian cancer, blood clots, heart disease or stroke, high blood pressure, and liver disease.
To treat symptoms of menopause, we can prescribe Hormone Replacement Therapy. It is used to relieve symptoms by replacing female hormones that drop in level as menopause occurs. There are numerous types of HRT that can be prescribed, based on your specific condition.
You can stop taking HRT usually two to five years after you start menopausal symptoms and gradually decrease the dose. You may have a relapse of symptoms, which should pass in a few months.