Hormone Replacement Therapy Q&A

What is hormone replacement therapy?

Hormone replacement therapy is a treatment that may be recommended when the natural production of your hormones, namely estrogen and progesterone, have reduced due to age or a hysterectomy.

Why is hormone replacement therapy necessary?

While hormones naturally decrease with age, that doesn’t make the process comfortable. Estrogen, along with progesterone, assists your body in metabolizing calcium, which is essential for bone health. This hormone also supports vaginal health and helps you manage your cholesterol levels. When the levels of these hormones drop in the years leading up to menopause, you’re vulnerable to uncomfortable symptoms including:

  • Hot flashes
  • Night sweats
  • Painful sexual intercourse

The sharp drop in your hormones also puts you at greater risk for osteoporosis and heart disease. Hormone replacement therapy isn’t permanent. It’s designed to help ease your body into lower levels of estrogen and progesterone, as opposed to the drastic drop that often occurs.

Who is a candidate?

Women who’ve undergone a hysterectomy prior to natural menopause benefit from estrogen-only hormone replacement therapy.

Women who are in perimenopause — the three to four years prior to menopause — with uncomfortable symptoms are candidates for estrogen with progesterone therapy. Estrogen naturally causes the lining of the uterus (or endometrium) to thicken and prepare for an egg implantation; this is the lining that’s sloughed off monthly during your menstrual cycle. Progesterone is the hormone that encourages this sloughing, thus reducing your risk of endometrial cancer.

Women who have a heightened risk of breast cancer or heart and liver disease, along with those who have a history of blood clots, should discuss the risks of hormone replacement therapy in their particular circumstances with their doctor. If you’re in perimenopause with few to no symptoms, hormone replacement therapy is most likely unnecessary.

How are hormones administered?

The method of hormone delivery depends on your preferences and what the doctors think will provide you with the most benefit. Pills, patches, injections, and time-released pellets implanted under your skin are all options.