Hormone Replacement Therapy

The most discussed and often controversial treatment for menopause is hormone-replacement therapy; commonly referred to as HRT. Before moving forward, it is important to know that your GP or gynaecologist is the best for discussing this treatment according to your body, medical history, and symptoms. You can find a list of menopause providers in the additional resources. With all the talk about HRT, this is meant to provide general information about this type of treatment. In Ireland, the Minister for Public Expenditure has intended to allow budget for HRT coverage in the future, hopefully in 2025

Understanding Hormones during Menopause

During the transition to menopause (12 consecutive months without a menstrual period), the body’s release of hormones undergoes significant fluctuations. These fluctuations in hormone production are the main cause of menopause symptoms
HRT is a medical treatment that involves the administration of hormones to replace those that the body no longer produces in sufficient quantities during menopause. The two primary hormones used in HRT are oestrogen and progesterone, although sometimes only oestrogen is prescribed. This is especially in the case of women who have had a hysterectomy.

Oestrogen is the key hormone responsible for regulating various bodily functions, such as controlling the menstrual cycle and maintaining bone density. During menopause, oestrogen levels decline, leading to a host of symptoms including hot flashes, night sweats, vaginal dryness, mood swings, and sleep disturbances. By replenishing oestrogen levels through HRT, many of these symptoms can be alleviated or even eliminated.

Progesterone, on the other hand, is often prescribed alongside oestrogen in HRT to protect the uterus lining from the potential risks associated with unopposed oestrogen therapy. Progesterone helps prevent the overgrowth of the uterine lining, reducing the risk of endometrial cancer. Women who have had a hysterectomy, however, do not require progesterone as there is no uterus to protect.

How is HRT Administered?

HRT can be administered in various forms, including pills, patches, creams, gels, and vaginal rings. The choice of delivery method depends on individual preferences, medical history, and the specific symptoms being targeted. For example, vaginal oestrogen creams or rings may be recommended for women experiencing vaginal dryness or discomfort during intercourse.

Potential Side Effects

While HRT can effectively alleviate menopausal symptoms, it is not without potential risks and side effects. Before starting HRT, it is crucial for women to have a thorough discussion with their healthcare provider to assess their individual health risks and benefits. Some women may have certain medical conditions or a family history that could make HRT less suitable for them. Additionally, the duration of HRT should be carefully considered, as prolonged use may increase the risk of certain health issues such as breast cancer, blood clots, and stroke.

HRT may not be advisable for people who:

• have a history of breast cancer, ovarian cancer or womb cancer
• have a history of blood clots – you may need to use patches or gels rather than tablets
• have untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
• have liver disease
• are pregnant – it’s still possible to get pregnant while taking HRT, so it’s important to use contraception until 2 years after your last period if you’re under 50, or for 1 year after the age of 50

One Piece of the Puzzle

It is important to note that HRT is not a one-size-fits-all solution, and its benefits and risks vary from woman to woman. Regular monitoring and follow-up with a healthcare provider are essential to ensure the treatment remains appropriate and effective. Furthermore, lifestyle modifications such as maintaining a healthy diet, engaging in regular exercise, managing stress, and getting enough sleep can also contribute to overall well-being during menopause.

Hormone replacement therapy (HRT) offers a viable option for women seeking relief from the troublesome symptoms associated with menopause. By replenishing oestrogen and, if necessary, progesterone levels, HRT can effectively alleviate symptoms such as hot flashes, night sweats, mood swings, and vaginal dryness. However, it is important for women to have open and honest discussions with their healthcare providers to assess the potential risks and benefits of HRT based on their individual health profile. With proper guidance and monitoring, HRT can be a valuable tool in navigating the journey through menopause and improving the overall quality of life for women.