Hormone replacement therapy (HRT) involves taking medications containing female hormones to treat common symptoms of menopause. It can also benefit women who have had their ovaries removed or have an underactive pituitary gland. HRT helps relieve hot flashes, night sweats, vaginal dryness and irritation, as well as sleep disturbances that can accompany menopause.
Women experiencing early menopause, either naturally or due to surgery, chemotherapy, or radiation therapy, are often good candidates for HRT. The sudden drop in estrogen levels causes more severe symptoms in early menopause. HRT can help ease this transition.
Perimenopausal women may also benefit from HRT to regulate their hormones while their bodies are transitioning into menopause. Taking combination estrogen-progestin therapy during the perimenopause and early postmenopause time periods has been associated with a decreased risk of cardiovascular disease.
HRT is an option for transgender women as part of their transition. Taking medications like estrogen and progesterone helps transgender women develop typical female secondary sex characteristics. HRT can be an important part of aligning their physical attributes with their gender identity.
Additionally, HRT may benefit women at higher risk for developing osteoporosis. Estrogen therapy helps conserve bone mineral density and reduce fracture risk. It can help support bone health, especially in slim, small-boned women with a family history of osteoporosis.
- Women experiencing severe menopause symptoms, like debilitating hot flashes, severe vaginal atrophy, and resultant pain with intercourse, are often good candidates for at least short-term HRT.
- Women with early or premature ovarian failure or insufficiency usually derive great benefit from HRT due to the abrupt decrease in sex hormones. Supplemental estrogen can help stabilize mood, energy, cognition, and urogenital function.
- Women with a history of premature fractures or strong family history of osteoporosis may consider HRT for bone support, in addition to weight bearing exercise, calcium, and vitamin D supplementation.
Some women, however, may not be good candidates for HRT due to health risks associated with taking supplemental hormones:
- Women diagnosed with an estrogen-dependent cancer, like breast cancer, may be advised not to take HRT. Supplemental estrogen could stimulate cancer cell proliferation. Progestins may also be contraindicated for some cancers.
- Women with a history of cardiovascular disease, blood clots, liver disease, gallbladder disease, and migraine headaches with aura should use caution with HRT. Estrogen raises the risk of blood clots and gallbladder issues.
- Women with undiagnosed vaginal bleeding should not take HRT until an evaluation rules out endometrial cancer. Estrogen without an opposing progestin can overstimulate the uterine lining.
In summary,
good candidates for HRT include women with early or premature menopause, perimenopausal women, transgender women, and those at high risk for osteoporosis. HRT can effectively treat symptoms like hot flashes, vaginal atrophy, sleep disruption, bone loss, and
mood changes associated with hormone changes. However, women with certain cancers, cardiovascular disease, blood clots, and other health conditions may not be suitable candidates. Working closely with a knowledgeable healthcare provider is important to determine if
hormone therapy aligns with your health status and goals.