Hormone therapy: what are your options?
Menopause is a natural phase in a woman's life during which levels of oestrogen and progesterone in the body start to fluctuate and decline, leading to various symptoms. Menopause is inevitable, but suffering through it is not. Hormone replacement therapy (HRT) can help to reduce symptoms by replacing the hormones no longer naturally produced by your body. What types of HRT are there? What type is right for you?
HRT is considered the most effective treatment for many menopausal symptoms. Typically, changes begin to emerge within a few weeks. – Dr. E.A.H. Knauff, gynaecologist
What is hormone therapy?
The body undergoes several hormonal shifts during menopause. In the years before your menstrual periods stop permanently, also called perimenopause, levels of oestrogen and progesterone start to decline. While testosterone also decreases during perimenopause, the balance of testosterone to oestrogen and progesterone gets thrown off during this period – so the amount of testosterone increases relative to these hormones. In 80 percent of women, these hormonal changes cause a wide range of symptoms. After menopause, your body adjusts and restores hormonal balance.
Hormone replacement therapy (HRT) replaces the female hormones that are at a lower level as you experience menopause. By stabilising oestrogen and progesterone levels, HRT can reduce or even eliminate symptoms caused by hormonal changes.
For many women, HRT has made their journey through menopause a lot smoother. They report that it helps reduce symptoms like sleep problems, hot flashes, vaginal dryness or itching, and that they have more energy and less painful muscles and joints.
Bioidentical or synthetic?
There are different types of HRT and they can contain different types of oestrogen and progesterone:
- Bioidentical hormones: Bioidentical hormones are hormones that have the same (identical) chemical composition as those produced by the body itself. They have similar effects as our natural hormones and are broken down in the same way. Bioidentical hormones are plant derived (from soy and yam). HRT with bioidentical hormones include Zumenon and Oestrogel (bioidentical oestradiol) and Utrogestan (bioidentical progesterone).
- Synthetic hormones: Synthetic hormones are artificial hormones that resemble our natural hormones but have a different biochemical structure (contraceptive pills also contain synthetic hormones). They are made in a laboratory and designed to mimic natural hormones' effects on the body. Progynova and Livial are options that contain synthetic hormones.
Most treatments that are prescribed contain bioidentical oestrogen (oestradiol, the most biologically active oestrogen), which has exactly the same effect as natural oestradiol. They often also contain a bioidentical progesterone or a synthetic progestogen (such as levonorgestrel or dydrogesterone).
What dosage forms are available?
HRT comes in various dosage forms. Your doctor will prescribe the type that is right for you based on your symptoms and personal preferences.
- Transdermal (via the skin): Gels, ointments and patches, such as Lenzetto and Oestrogel. Transdermal medications are applied to the skin and go straight into the bloodstream, bypassing the liver. Especially for women with an increased risk of thrombosis, transdermal routes are preferred. Another advantage is that less of the medicine is required.
- Oral: Tablets and capsules, such as Femoston and Kliovance. Although convenient, orally administered medications are metabolised in the liver, which increases the risk of side effects.
- Vaginal: Cream and suppositories, such as Vagifem. A low dose of the oestrogen is inserted into the vaginal cavity to alleviate vaginal symptoms without subjecting the rest of the body to high levels of hormones.
What type of HRT and dose is right for me?
It is difficult to say what type of HRT will work best. Some women may respond better to bioidentical hormonal options, others to synthetic options or a combination of both. You can select a treatment based on your symptoms and preferences. Your order will be reviewed by a doctor. The doctor may prescribe HRT or suggest alternatives based on your medical information.
In consultation with you, the doctor will also decide what dose to use. The goal is to prescribe the lowest dose to treat your symptoms for as short as necessary. Therefore, HRT is usually started at a low dose and gradually increased. It may take a few months to find the right type and dose.
There is no set length of time you should take HRT for. The duration of treatment is highly individual and depends on your situation and symptoms. The average length of time that women use HRT to ease menopausal symptoms is around five years. Doctors usually treat for as long as necessary and gradually lower the dose once the symptoms are under control.
Start your HRT treatment with expert guidance
Like any medical treatment, hormone therapy has risks and side effects. Therefore, HRT should always be prescribed and monitored by a healthcare professional. Start your HRT treatment with expert guidance from a SeeMe-nopause doctor.
How does it work? Select your preferred product based on your symptoms and various other options. Add the product to your shopping cart and complete the medical questionnaire. A doctor will review your order within 48 hours to ensure the treatment is the right option for you. The pharmacy will ship your order to your home within three working days.
Women need to know that they don’t have to suffer in silence. HRT is a safe way to manage many servere symptoms of menopause. – Dr. E.A.H. Knauff, gynaecologist
What if you cannot or don't want to use HRT?
Not everyone wants to use hormones and for some women it's contraindicated. For instance, women who have had breast cancer are not usually prescribed HRT. For women who choose not to use HRT or cannot use HRT, there are other treatments available.
- Non-hormonal medication: Some symptoms of menopause, such as weight gain and hot flashes, can be treated with non-hormonal medication. Options include Veozah and Clonidine (for hot flashes).
- Dietary supplements: Supplements influence the production, conversion or breakdown of hormones. They help improve hormonal balance, which in turn can help relieve specific symptoms*. Hormone therapists recommend magnesium, omega-3, Vitamin D and a vitamin and mineral complex during menopause.
- Diet and lifestyle: The impact of lifestyle on menopausal health should not be underestimated. Good health starts with a healthy lifestyle. Even if you are using medication or supplements, you may also need to have a look at lifestyle changes. More about a healthy lifestyle.
* Health claim pending approval by the European Commission.
What do we know about the risks and benefits of HRT?
Suffering from menopausal symptoms? Hormone replacement therapy (HRT) may help. What do we know about HRT? What are the risks or health benefits?
FAQ
Who is SeeMe-nopause?
SeeMe-nopause was founded on the initiative of a group of women and is part of the eHealth Ventures Group, a leading organisation specialising in digital health solutions with platforms in 14 countries.
With a team of doctors and menopause specialists, we provide access to information and supplements. We will also offer medicinal products and therapies in the near future. Our goal is to give women the tools they need to not only survive but thrive through perimenopause and beyond. More about us.
How do I know if your information is reliable?
Our recommendations are based on scientific research and always reviewed by our independent Medical Advisory Board. This is how we help you navigate your journey through menopause safely and responsibly.
Sources
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- Bailey E, Seladi-Schulman J. Medical News Today. (2023). Menopause: New study lists the benefits of hormone replacement therapy. https://www.medicalnewstoday.com/articles/managing-menopause-hormone-therapy-is-back#Benefits-of-HRT-menopause-treatment
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