How Will I Feel On Hormone Replacement Therapy (HRT)?

When a woman passes through menopause, she stops having menstrual periods, and the process can sometimes lead to a variety of other symptoms, including hot flashes and vaginal dryness.

According to the American College of Obstetricians and Gynecologists, you can reduce menopause symptoms with estrogen and/or progestin with HRT (ACOG). Women can only take estrogen if they have undergone a hysterectomy, so they need to take estrogen and progestin if their uterus is still around.

Two forms of hormone therapy, systemic and local, are available. According to the ACOG, hormones are released into the bloodstream with systemic therapy and go to the organs and tissues that need it. According to ACOG, local therapy is for women who only suffer from vaginal dryness.

HRT can be beneficial, according to the ACOG, by:

• Helping with dryness of the vagina
• Protecting against bone loss that can result in fractures of the hip and spine
• Risk reduction for colon cancer
• Relieving hot flashes, especially during the night

There are also risks to HRT, according to the ACOG. Some risks include:

• Breast cancer (small but increased risk)
• Deep vein thrombosis (small but increased risk)
• Gallbladder (small but increased risk)
• Heart attack (small but increased risk)
• Stroke (small but increased risk)
• Uterine lining growth, which can increase the risk of uterine cancer

According to ACOG, HRT is currently approved for use in the treatment of menopausal symptoms, but only on a limited basis. It is recommended that women take time to assess the risks and benefits and discuss the best choice for their individual health needs with their doctor.

The ACOG also advises that women who have opted to take HRT should use the lowest effective dosage for the shortest time possible.

When to stop taking HRT

After their menopausal symptoms end, most women are able to stop taking HRT, which is normally two to five years after they start.

It is generally advised to gradually decrease your HRT dose, rather than stop abruptly. After you quit HRT, you can have a relapse of menopausal symptoms, but within a few months these should pass.

Contact your GP if you have symptoms that continue for several months after you quit HRT, or if you have especially serious symptoms, so you will need to restart your medication, usually at a lower dose.

You will need additional medication for vaginal dryness and to avoid osteoporosis after you have stopped HRT (brittle bones). Learn about the best ways osteoporosis can be avoided. For vaginal dryness, creams and lubricants are available, as are local oestrogen preparations.

Who can use HRT?

You can start HRT as soon as you start to experience menopausal symptoms. However, HRT may not be appropriate if you are pregnant or have:

• a history of breast cancer, ovarian cancer or womb cancer
• a history of blood clots
• a history of heart disease or stroke
• untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
• liver disease