Hormone Replacement Therapy Before and After Menopause
Hormone replacement therapy (HRT) provides a woman’s body with adequate amounts of estrogen or estrogen and progesterone during perimenopause, also called premenopause, and after menopause. The ovaries produce estrogen and progesterone throughout a woman’s life. When menopause nears, the ovaries reduce production of these important hormones and production ceases completely with the onset of menopause. The process usually begins in the 40s, but can begin in the 30s or earlier in some cases.
What to Expect
You may experience premenopausal symptoms due to the reduction of estrogen and progesterone in your system. These symptoms include mood swings, loss of libido, hot flashes, insomnia, fatigue, vaginal dryness, urinary incontinence and increased premenstrual symptoms. Reduced levels of estrogen can increase your risk for osteoporosis, leading to broken bones. Estrogen replacement can relieve many symptoms associated with perimenopause and reduce the risk for osteoporosis.
Women who have not had a hysterectomy must take a combination of estrogen and progesterone. The progesterone protects the uterus from endometrial cancer by causing the uterus to shed endometrial cells monthly. As a result, you may have some monthly bleeding, but taking a progesterone/estrogen combination can often relieve monthly bleeding.
Determining if You Need HRT
If you notice the onset or frequent recurrence of any of the common premenopausal symptoms listed above, make an appointment with your OB/GYN to discuss your concerns. Have a list of questions ready along with duration and types of symptoms you are experiencing. Your OB/GYN doctor may ask about the dates of your symptoms and if they are affecting your daily routines. He or she will determine whether HRT is an appropriate treatment for you based on your concerns and your medical history and current health status. The physician may order routine blood tests and perform a full physical to aid in the decision making process.
Delivery Methods for HRT
Estrogen and progesterone therapies are available in a variety of forms. If you have had a hysterectomy and do not need progesterone, your doctor may prescribe estrogen in the form of pills, vaginal cream, vaginal ring, vaginal tablet, or a patch. If you need progesterone as well, it is available in pills or vaginal gel formulations. Combination therapies containing both estrogen and progesterone are sold in pill and patch formulations. Your OB/GYN can determine which method of drug delivery will work best for your individual medical needs and lifestyle.
Alternative Treatment Options
Alternative, or non-traditional, treatments can be used alone or as an adjunct therapy along with HRT. Some women may find relief from menopausal symptoms with regular exercise and a healthier diet. Including supplements containing phytoestrogens, a weak estrogen-like substance derived from plants, in their daily routine may offer relief to some. Herbal remedies such as black cohosh and flaxseed are suggested to reduce frequency of hot flashes and night sweats. Use these herbal remedies with caution. The federal government does not regulate herbal supplements as they do prescription and over the counter drugs. Because of this, manufacturers do not follow any standardization requirements in the manufacturing process. The supplements could have too little or too much of the herb, causing patients to take incorrect dosages.
Take care when trying the various herbal remedies available, as there is little to no scientific evidence available to support or refute the claims of their proponents. Always discuss your plans to try alternative remedies with your physician before adding them to your diet or supplementary regimen.
HRT is Not Appropriate for Everyone
Women who smoke cigarettes or have a history of blood clots or stroke should not use HRT. Those with liver disease or history of breast cancer should discuss alternative treatment options with their physicians. The risks of HRT outweigh the benefits for women with these conditions.
About the Author
Samantha Gluck is a freelance writer specializing in various topics including pediatric healthcare, OB/GYN healthcare, business and much more.
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