Hormone Replacement Therapy (HRT) Options

Generally, HRT becomes necessary when a woman is going through menopause and experiencing severe symptoms that disrupt daily life. These symptoms can include debilitating hot flashes, persistent night sweats, mood swings, and other physical or emotional changes that are tied to hormonal imbalances. Additionally, HRT can be necessary for individuals who are at risk of, or are already dealing with, conditions related to low hormone levels. For example, people with osteoporosis, which weakens bones and increases the risk of fractures, may benefit greatly from HRT. HRT is also considered necessary for individuals with certain hormonal deficiencies that could impact their overall health and well-being. The necessity of HRT is not uniform for everyone and should be evaluated on a case-by-case basis

There are a variety of HRT options. The various options can contain different hormones, e.g., estrogen, progestogen, or both, and sometimes testosterone. They can be taken or used in different ways – tablets, patches, gel, spray or vaginal rings, pessaries or cream. They can be taken or used at different times – routines can be cyclical (sequential) or continuous. The type of HRT that is best depends on different factors, like if the patient has had a hysterectomy, their stage of menopause, and personal preference or lifestyle. Choices include:

1. Tablets or troches- Oral methods such as tablet or troches are one of the most common forms of HRT, usually taken once a day.
2. Patches – Skin patches work by sticking onto the skin on the lower part of the body and gradually releasing small amounts of hormones into the body. The patch is changed every few days, but each brand is different. Both estrogen-only and combined hormones are available as skin patches.
3. Estrogen gel – The gel is smoothed onto the skin once a day. Estrogen is gradually absorbed into the body.
4. Estrogen spray – Estrogen comes in a spray used once a day, spraying 1 to 3 sprays onto the inner side of arms or inner thighs.
5. Estrogen ring – Vaginal ring delivery systems are soft, flexible rings inserted into the vagina that release estrogen over a 3-month period.
6. Vaginal estrogen – Low dose estrogen is available as a cream, gel, vaginal tablet, pessary or ring that is put inside the vagina. This is particularly helpful with menopausal symptoms such as vaginal dryness, a burning sensation, or pain during sex.

The main benefit of HRT is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings, insomnia, and vaginal dryness. HRT additionally improves bone health to prevent fractures caused by osteoporosis, makes some women less likely to have heart disease, and lowers chances of dementia. However, there are also risks associated with HRT such as blood clots, stroke, breast cancer, and endometrial cancer. Benefits vs. risks should be discussed with one’s healthcare provider to ensure the best treatment is prescribed for each person. Learn more at https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372