During perimenopause and menopause the levels of female hormones can go up and down.
This can cause menopausal symptoms such as hot flashes, night sweats, pain during sex, and vaginal dryness. Hormone replacement therapy (HRT) is a treatment option that can relieve these symptoms.
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What is HRT?
Hormone replacement therapy (HRT) includes medications that contain female hormones. HRT is commonly used during menopause to alleviate the symptoms associated with changing hormone levels.
Is HRT safe?
The use of hormone replacement therapy has been variable over time. HRT use is often decided with your provider, and based on your health history, preference for using hormones, and severity of menopausal symptoms.
What are the risks?
Like all medications, there are risks associated with the use of hormone replacement therapy. HRT may slightly increase your risk of blood clots, and when introduced later in the menopause transition and in older women, has the potential to increase the risk of dementia and heart disease. Combination hormone therapy might slightly increase your risk of breast cancer if it is used for more than 4 to 5 years. Estrogen therapy alone might increase breast cancer risk if used for longer than 7 years. It is important to note that while this risk is present, it is rare.
Treatment Options
The main HRT treatments that exist can be broken down into 2 categories:
- Estrogen therapy (in the form of pills, creams, rings, patches, sprays)
- Combination therapy (estrogen and progesterone)
What to expect on your visit
During your visit, you can expect your care team to listen to and address all of your concerns in a safe and trusted space. A consultation for hormone replacement therapy may include:
- A history and physical examination
- Labs
Many years ago, the consensus was that HRT should be taken at the lowest dose for the shortest amount of time. However, it has been well-established that HRT supports bone, brain, and heart health, and menopausal symptomatic relief. Stopping of HRT is at the patient’s discretion. If another condition develops and precludes you from taking HRT, it will be stopped.
A woman cannot take hormone replacement therapy if she has: a prior history of a blood clot, any gene mutation that increases cancer risk, a high cardiovascular risk profile, or a personal or family history of breast or gynecologic cancers (lifetime risk of 20% or greater).
Questions about your sexual health or menopause? Learn more.
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