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  • Writer's pictureHarshvir K

The pros and cons of HRT for menopausal women.

Updated: Jul 1

Credit: Unsplash (1)

We know that menopause can be scary, but the situation is never hopeless. There are therapies that you can consider which reduce menopause-associated symptoms and health risks!

Currently there are no treatments that kickstart your ovaries and cancel menopause. But there are treatments that supplement for ovarian sex hormones called hormone replacement therapies (HRTs).

(2) Fluctuations in estrogen and progesterone from birth to post menopause.

Menopause symptoms and health risks.

Once menopause hits, you’ll stop getting periods. (Read more about menopause here.) During this period, you'll experience some uncomfortable symptoms, including:

  • Irregular periods.

  • Vaginal dryness.

  • Hot flashes.

  • Difficulty sleeping.

  • Mood swings.

  • Weight gain. (3)

You'll also experience some heightened health risks for the following diseases:

  • Heart disease.

  • Osteoporosis.

  • Arthritis.

  • Dementia. (4)

What are HRTs?

HRTs are highly recommended drugs that supplement estrogen and sometimes, progesterone in the body. Most menopause symptoms and health risks are due to a critical drop in estrogen levels, which is why they can be addressed with this estrogen boost!

(5) Hormone levels with aging and the difference with HRT’s

Do the benefits outweigh the risks?

It depends. Women are recommended to go on HRTs during menopause but stop taking HRTs after a few years. There is no real limit to how long you can take HRTs, but there historically, there have been studies that demonstrated an increased risk of cancer and heart disease in women who started taking HRTs a decade after menopause. (6)

To be clear, studies done on younger women, closer to the menopausal period, agree that the benefits of HRT exceed the risks. (7)

There are ways you can reduce the risks that come with HRTs. The most common is taking HRT with progesterone.

With or without progesterone?

There are two main types of hormone therapy (HT):

  • Estrogen Therapy: Here estrogen is taken alone. Doctors usually prescribe a low dose of estrogen to be taken as a pill or patch every day.

  • Estrogen Progesterone/Progestin Hormone Therapy (EPT): Also called combination therapy, this form of HT combines doses of estrogen and progesterone. (8)

Progesterone is an important hormone in the female body, used to mainly regulate the condition of the inner lining (endometrium) of the uterus. Menopausal women with a uterus are always prescribed estrogen with progesterone to reduce the risk of endometrial cancer. (9)

The pros and cons of HRT.

Every important decision must be made with a pros and cons list! This treatment is not risk-free. You reduce your risk for several diseases, but you can also increase your risk for others. Here are the main pros and cons of HRT.

The pros:

  1. Reduced symptoms of hot flashes and night sweats.

  2. Reduced risk of cardiovascular disease.

  3. Reduced risk of dementia.

  4. Reduced risk of osteoporosis.

The cons:

Those with health conditions such as diabetes, liver disease, or a history of strokes, ovarian cancer, blood clots, etc. are often not medically permitted to take HRT. This is due to some of the increased health risks and side effects associated with HRTs, such as.

  1. Increased risk of breast/ovarian cancer.

  2. Increased risk of heart disease.

  3. Increased risk of blood clots in the lungs.

  4. Increased risk of Alzheimer’s disease.

  5. Headache, nausea, vaginal bleeding side effects. (3)

The professional opinion.

Although there is some controversy surrounding HRTs, they are the medical recommendation for menopausal women. The benefits continue to outweigh the risks up to ten years after menopause.

Before taking HRTs, the woman’s quality of life, personal risk factors such as age, time since menopause, and her risk of blood clots, heart disease, stroke, and breast cancer should be taken into consideration. (10)

Key Takeaways.

  • HRTs are recommended to treat menopausal symptoms and associated health risks.

  • There is no limit to how long you can take HRTs, but it's usually recommended up to a few years after menopause onset.

  • HRT can be provided through estrogen therapy or Estrogen Progesterone/Progestin Hormone Therapy (EPT).

  • A dosage of estrogen in combination with progesterone could reduce the risk of endometrial cancer.

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