What is menopausal hormone therapy?
Taking medicine to replenish the oestrogen lost during the menopause is known as menopausal hormone therapy, or more precisely, hormone replacement therapy.
Among the various forms of hormone replacement therapy is menopausal hormone therapy.Additionally, hormone replacement therapy can be provided to:
- men experiencing a loss in testosterone as part of the “male menopause”
- transgender people looking to align their secondary sexual characteristics with their identified gender
Why is menopausal hormone therapy done?
As women approach the menopause their levels of oestrogen fall, leading to a number of uncomfortable symptoms such as:
- hot flushes
- mood swings
- loss of libido
- vaginal dryness
Hormone replacement can help to maintain the levels of oestrogen in the body, and combat some of these symptoms.
It’s particularly recommended in women who experience an early menopause, as they are at a higher risk of heart disease, anxiety, depression, or parkinsonism if their oestrogen levels are too low.
Finally, hormone replacement therapy has also been found to help prevent bone loss and reduce the risk of fragility fractures.
Hormone replacement therapy is not likely to be recommended if you have a history of womb, ovarian or breast cancer, or if you have a history of blood clots.
What does menopausal hormone therapy involve?
Hormone replacement therapy entails consistent medication use.
The drug can be taken in a variety of forms, such as a skin patch, cream, or pill. Additionally, you can take the drug continuously or in cycles.
In order to lower your risk of uterine cancer, you will probably need to take progesterone in addition to estrogen unless you have had a hysterectomy.
Before deciding, it’s crucial to have a thorough conversation with your doctor about the advantages and disadvantages of hormone replacement treatment. Hormone replacement therapy has numerous advantages (as mentioned above), but it also raises your risk of stroke and breast cancer. Some possible side effects are:
- bloating and indigestion
- headaches
- tenderness or swelling in your breasts
- nausea
- vaginal bleeding
What are the alternatives?
If you ultimately feel that the risks and side effects for you outweigh the benefits, there are alternative ways of tackling menopause symptoms you can consider:
- alternative medication – to tackle symptoms such as hot flushes or night sweats, your doctor may recommend trying tibolone,clonidine, or in some cases, antidepressants. These have their own risks and side effects and these should be discussed thoroughly
- vaginal lubricant or moisturiser may tackle symptoms of vaginal dryness
- regular exercise can reduce hot flushes and boost your mood
- dietary changes – a healthy diet can keep your bones strong and help you maintain a healthy weight. Cutting down on caffeine or alcohol in particular can reduce hot flushes
- Sleep hygiene – you can help improve your sleep by relaxing before going to bed, and making sure the room is cool to avoid night sweats
What are the risks of HRT?
Hormone replacement therapy can come with some risks, however in most cases these are outweighed by the benefits. The risks include:
- Heart disease
- Blood clots
- Breast cancer
- Stroke
The risks of HRT vary a lot depending on factors such as:
- Age: if you begin HRT before the age of 60, then you are at a much less likely to suffer from the above risks.
- Dosage: the risk of developing problems due to HRT depends on the given dose.
- Progestin: the risks of hormone replacement therapy are much greater if just oestrogen is given, as opposed to oestrogen given in combination with progestin.
- General health history: another important indicator of whether or not hormone replacement therapy is right for you is the health history of you and your family. If there is a history of heart disease, cancer, stroke, blood clots, osteoporosis or liver disease, HRT may not be suitable for you.
- High blood pressure: If you have a history of high blood pressure, you will need to lower it and get it under control before you can start HRT.
- Pregnancy: HRT is generally not suitable for pregnant women or women who breastfeed.
Before beginning your hormone replacement therapy, your doctor will discuss all of these risk factors with you in detail.
How does HRT work for transgender women?
HRT for transgender women, also referred to as feminizing hormone therapy, is the use of hormone medication, primarily oestrogen, to help transgender women feel as though their bodies more closely reflect their gender identity. Additionally, it aids in preventing the male hormone testosterone from being produced.
The patient will eventually begin to notice several changes in their body as a result of the oestrogen component of the hormone therapy, including:
- Skin that is softer
- Breasts
- A shift in body shape, such as increased body fat on the face, buttocks, and hips.
Anxiety and mood swings may also result from it.
Blocking the body’s ability to produce testosterone is another aspect of feminizing hormone therapy. Changes like decreased libido, smaller testicles, less facial and body hair, decreased muscle mass, and fewer erections and ejaculations will result from this.
Although it may take up to three years to notice the effects, the aforementioned changes typically begin to take effect after about a month.
Why do transgender women undergo HRT?
HRT is used to help transgender women better match their gender identity with their physical appearance. According to studies, it can significantly enhance transgender people’s psychological wellbeing by reducing the symptoms of psychological distress linked to gender dysphoria.