The Pros and Cons of Hormone Replacement Therapy



Menopause is defined as the point when a woman’s menstrual cycles permanently cease. The average age for women to hit menopause in the U.S. is 51 years old, but some women begin experiencing menopause-like symptoms in their 40s during a transitional period called perimenopause.

During perimenopause  and menopause, a woman may experience many symptoms brought on by the changing levels of hormones––mainly the decrease of estrogen and progestogen––produced by the ovaries. During this time, the decline in reproductive hormones can cause hot flashes, night sweats, headaches, insomnia, fatigue and vaginal dryness, among other unpleasant symptoms. Doctors may recommend hormone replacement therapy for healthy women struggling with these symptoms. 

Estrogen-only therapy can be prescribed for women without a uterus due to a hysterectomy, while estrogen plus progestogen therapy can be prescribed for women with a uterus. Doctors most often prescribe a low dose of estrogen to be taken as a pill or patch every day, but it can also be prescribed as a cream, vaginal ring, gel or spray, among others. Hormone replacement therapy should be used at the lowest dose that helps and for the shortest time.

As with any medication, there are benefits and risks to consider. 

What are the benefits of hormone replacement therapy?

  • Treatments are effective at relieving menopausal symptoms, especially hot flashes, night sweats and vaginal discomfort from dryness.
  • Women are at an increased risk for developing osteoporosis as their body’s natural bone-building process gets interrupted with a decline in estrogen levels. Estrogen helps preserve calcium in the body. Hormone replacement therapy has been proven to prevent bone loss and reduce fractures in postmenopausal women.  

What are the risks of using hormones?

  • For some women, hormone replacement therapy may increase their chances of getting blood clots, heart attacks, strokes, breast cancer and gall bladder disease. 
  • Taking estrogen increases a woman’s chances of getting endometrial cancer, a cancer of the uterine lining. For women with a uterus, progestogen must be prescribed along with estrogen to protect against cancer. 

Risks associated with hormone replacement therapy depend on a multitude of factors, including the type of hormone therapy, the dose and the length of treatment. 

Hormone replacement therapy is not suitable for all women, and you should discus the pros and cons with your doctor. If menopause symptoms are affecting your daily life, your doctor can recommend lifestyle changes or prescribe other medications that may help you find relief. 

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