Hormone Replacement Therapy
As women approach menopause, the production of estrogen and progesterone fluctuates and then decreases significantly. Symptoms such as hot flashes often result from the changing hormone levels. After a woman's last menstrual period, when her ovaries make much less estrogen and progesterone, some symptoms of menopause might disappear, but others may continue. This transition and its symptoms are different for every woman.
To help relieve menopausal symptoms, some women use hormones. This is called menopausal hormone therapy (MHT), or what was formerly known as hormone replacement therapy (HRT). Treatment with MHT not only eases symptoms, but also can address conditions related to menopause, such as increased risk of heart disease and bone loss. Several different hormone combinations for MHT are available in a variety of forms and doses.
How is hormone therapy administered?
According to the American Medical Association, hormone therapy can be administered in a variety of methods, including:
- Estrogen pills
Estrogen pills can either be taken every day or for 25 days each month. Women who have had a hysterectomy can take estrogen alone, while those who have not may take a combination pill (estrogen and progestin).
- Estrogen/progestin pills
There are two methods for taking estrogen and progestin - the continuous method and the cyclic method: - In the continuous method, a pill that contains both estrogen and progestin is taken daily. Occasionally, irregular bleeding may occur. - The cyclic method involves taking estrogen and progestin separately—with estrogen taken either every day or daily for 25 days of the month and progestin taken for 10 to 14 days of the month. This may cause monthly "withdrawal" bleeding.
- Estrogen and estrogen/progestin skin patches
Using this method, a patch is applied to the skin of the abdomen or buttocks for 3 or 7 days. The patch is then discarded and a new one is applied. The patch can be left on at all times, even while swimming or bathing, and either the estrogen, or estrogen/progestin combination is delivered through the skin into the bloodstream. Progestin can be taken in a pill form with the patch. The patches may cause monthly bleeding.
- Estrogen cream
Estrogen cream is inserted into the vagina or used locally around the vulva to help with vaginal dryness and urinary problems.
This estrogen-like drug (sometimes called "designer estrogen") is part of a new class of medications called selective estrogen receptor modulators (SERMs). For women who are appropriate candidates, this therapy can be customized to provide optimal benefit with the least side effects.