If you are experiencing symptoms during menopause, you might consider hormone replacement therapy. Hormone therapy (HRT or HT) is a temporary treatment that supplements sex hormones (oestrogen and progesterone). It can stabilise hormone levels, reduce fluctuations, and help alleviate symptoms such as hot flushes, mood swings, and vaginal dryness.
How does HRT work? Is it suitable for every woman? And what else is important to know? Here are 10 frequently asked questions and answers about HRT for menopausal symptoms.
A healthy body allows you to do the things you want without discomfort or limitations. Menopause can have such a significant impact on your body and mind that it restricts you. If a healthy diet, sufficient exercise, and relaxation do not help alleviate your symptoms, you can consult a doctor about HRT.
Women who use hormone therapy often report better sleep, no more hot flushes, reduced muscle and joint pain, less vaginal dryness, and increased energy. In other words, it helps many women navigate menopause more comfortably.
Hormone therapy is not a one-size-fits-all solution, but for those experiencing disruptive symptoms, it can be an important step towards greater balance and quality of life.
HRT involves administering female sex hormones (usually oestrogen and progesterone). The exact composition of these hormones depends on the nature of your symptoms, medical history, and the stage of menopause. There are several methods of administration:
The best method for you depends on your situation and symptoms. Oestrogen can be administered through the skin to bypass the gastrointestinal tract and liver, which may result in fewer side effects for some women. Patches and creams generally provide more stable hormone levels than gels, but absorption varies from person to person. You can always switch to another method if the first choice does not suit you.
HRT typically combines the female sex hormones oestrogen and progesterone. Oestrogen (estradiol) can relieve the symptoms of menopause. Progesterone (or its synthetic form, progestogen) controls the growth of the uterine lining and protects against uterine cancer.
Some studies suggest that progesterone may play a positive role in sleep, bone health, and mood, but it is not a standard part of HRT for women without a uterus.
Bioidentical hormones have the same molecular structure as the hormones in your body, allowing them to function similarly in the body. They have comparable effects and are broken down in similar ways. Synthetic (artificial) hormones have a different biochemical structure than your body’s hormones.
HRT can cause side effects, such as headaches and nausea. Whether and how much you experience side effects depends on the substance, dosage, and your individual response.
Hormone therapy today often includes bioidentical oestrogen, but you can choose between bioidentical progesterone or synthetic progestogen. Neither is inherently better than the other. The choice depends on your situation. It is impossible to predict which will work better for you.
No, not all women can safely use HRT. It is not recommended for women with breast cancer, hormonal cancers, blood clots, liver diseases, strokes, heart problems, or abnormal vaginal bleeding.
Your age also plays a role. Women over 60 or those who had their last period more than ten years ago face higher risks (an increased risk of breast and uterine cancer and a slightly higher risk of cardiovascular disease and stroke). For women over 60, the disadvantages of HRT often outweigh the benefits.
If HRT is not an option for you, there are alternative (hormone-free) medications to manage your symptoms.
There are various ways to restore hormonal balance, depending on your symptoms, preferences, and medical history. A doctor can help determine which hormone therapy is best suited to your situation.
Yes, HRT can reduce mood swings and feelings of restlessness or sadness.
Mood swings are caused by fluctuating hormone levels. When oestrogen fluctuates, the happiness hormone serotonin fluctuates as well, which can lead to mood issues.
Progesterone also has a calming effect. When hormone levels drop, you may suddenly feel restless or down.
HRT can stabilise oestrogen and progesterone levels, reducing mood fluctuations and helping you feel more at ease. In some cases, additional treatments, such as therapy or antidepressants, may be necessary.
Weight gain during menopause is often attributed to hormonal changes in the body. Up to 70 per cent of women gain weight during menopause, averaging half to one kilogram between the ages of 50 and 60.
Hormone therapy usually does not lead to weight gain. However, it is important to maintain a healthy diet and exercise regularly during hormone treatment. A healthy lifestyle remains the foundation of a healthy body.
Want to lose weight during menopause? A hormone therapist explains how to maintain your weight.
Low oestrogen levels increase the risk of cardiovascular disease. HRT can reduce this risk in women in perimenopause or early postmenopause, but for women over 60, the risk of cardiovascular disease may increase. Your family history (do your parents or grandparents have cardiovascular disease?) and the type of hormone also play a role.
There are no fixed guidelines for stopping HRT. Whether you stop abruptly or gradually taper off depends on your symptoms, side effects, and preferences. Doctors usually recommend tapering off HRT gradually over a few months. This significantly reduces the likelihood of your symptoms temporarily returning.
The risks of HRT have been studied and debated for years. A study by the Women’s Health Initiative over 20 years ago suggested that HRT might increase the risk of breast cancer and have negative health effects.
More recent research paints a different (and more positive) picture. Studies now show that HRT is a safe and effective treatment for most women. The risks identified in the WHI study primarily apply to women who start HRT later in life (60+). It is important to start HRT shortly (within ten years) after menopause. Age and context are therefore key factors in determining the risks.
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