Hormone replacement therapy is most commonly used to treat health issues and symptoms related to menopause. During menopause many women experience symptoms that are caused by the decline in estrogen and progesterone produced in the women’s body. Hormone replacement therapy involves the use of estrogen, progesterone, and androgens to compensate for the decline in natural hormone production.
Estrogen is a woman’s growth hormone that is responsible for the development of female sex organs and the physical shape of a female body. The woman’s body never stops producing estrogen during menopause but the amount of estrogen produced is too insignificant to support the function of the aging body.
The benefits of estrogen used in hormone replacement therapy include reduce hot flashes, maintain vaginal and urethral tissues, improve blood cholesterol levels, increase bone mass, reduce the chance of getting Alzheimer’s disease, diminish urinary tract problems, lower the risk of arthritis and Parkinson’s disease, and lower the risk of colorectal cancer.
The side effects associated with only the use of estrogen can lead to endometrial cancer or cancer of the uterine lining. If the woman’s uterus is intact, hormone replacement therapy always involve the combination of estrogen, progesterone, and androgens (testosterone) to lower the risk of endometrial cancer.
If the woman’s uterus is removed through the process of hysterectomy she has no need to worry about endometrial cancer and she can be treated only with estrogen a treatment called Estrogen Replacement Therapy (ERT). High level of estrogens can also contribute to blood clots in the deep veins of your legs or in your lungs or eyes and if you have previous history of these conditions HRT may increase the risk of recurring blood clots.
Progesterone is produce by the ovaries during the process of ovulation. Progesterone has a counter balance effect and together with estrogen help prepared the endometrium for implantation of fertilized egg as a result help keep the cycle in check and predictable. Progesterone level decline when a woman failed to ovulate and this effect her regular cycle causing irregular periods that usually occur during perimenopause. The main purpose of progesterone in HRT is the counter balance effects that help to reduce the risk of endometrial cancer for women with intact uterus.
Despite the fact that progesterone help to reduce the risk of endometrial cancer, the use of progesterone also come with side effects when used along with estrogen and these include some women experiencing breast tenderness, water retention, and mood swings. For this reason many doctors do not prescribed progesterone for women who had their uterus removed. There are different types of progestins available depending on individual’s medical history and the method of delivery that is best suitable for each individual.
Androgen or testosterone is a male hormone that is produce in small quantity by the ovaries during ovulation. Androgen level decline during menopause when the ovaries ceased to ovulate. Some studies indicate when androgen combined with estrogen may help promote the growth of healthy bone and some studies also indicate androgen may help increase sex drive. Androgen is use in HRT only in cases where women experience severe hot flashes or reduced sex drive and their conditions has not improved from traditional HRT. The side effects associated with the use of androgen include acne, increase facial hair, and oily skin.
Other than the risk of endometrial cancer and blood clots, HRT may also increase the risk of breast cancer, heart disease, and stroke. Long term use of HRT for five years or more may lead to breast cancer. Women suffering from liver disease should avoid HRT because the liver is responsible for the breakdown of estrogen and if the liver cannot breakdown the estrogen components HRT will not be effective.
There are different
forms of HRT available depending on individual preference and medical
history. These include pills, patches, skin gel, vaginal cream, and
vaginal ring. You may need to try more than one form that best suitable
for you to determine the one that works best for you with the
recommendation of your doctor.
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