What Is Hormone Replacement Therapy (HRT)?



Menopause is a natural condition that every woman experiences in her lifetime. Several studies reveal that approximately 80% of menopausal women show some symptoms while a quarter of those women show severe symptoms of menopause. To overcome these symptoms that can take a toll on your overall health, hormone replacement therapy is being introduced as it is considered an effective treatment for menopause-related symptoms.

In this blog, we’re going to discuss some information about hormone replacement therapy, its types, benefits, and risks such as whether it can cause hair loss. So, keep on reading.

What is hormone replacement therapy?

Hormone replacement therapy (HRT) is a kind of treatment to relieve menopausal symptoms. These symptoms are usually caused by a lower level of estrogen (a female hormone that maintains the normal sexual and reproductive development in women).

What is menopause and what are its symptoms?

Menopause is not an illness but a natural transition from the years in which a woman can reproduce to the next phase of life. The common symptoms of menopause are:

  • Hot flashes
  • Night sweating
  • Sleep disturbance
  • Vaginal dryness
  • Low sex drive
  • Mood swings
  • Osteoporosis or bone thinning
  • Hair thinning
  • Irregular periods
  • Difficulties with memory and concentration
  • Mild depression
  • Dry skin, eyes, and mouth

We would also like to give you some background information about menopause before discussing it in depth. There are three basic stages of menopause.

Perimenopause – the time between the onset of symptoms such as erratic periods and a year after the final menstrual period

Menopause – the confirmation of no periods after a year of the final menstrual period

Postmenopause – stage of all the years after menopause

Types of HRT

There are two basic types of hormone replacement therapy.

ET Therapy – this means estrogen-only therapy. In this therapy, only estrogen hormones are introduced to women who have had their uterus removed through hysterectomy.

EPT Therapy – this means combined estrogen plus progesterone therapy. In this therapy, another hormone progesterone is added to treat women with a uterus. The role of progesterone here is to protect women against endometrial cancer from estrogen alone.

How can you take HRT?

There are two general ways to take hormone replacement medications.

Systemic medications – these medicines are available as an oral tablet, patch, gel, emulsion, spray, or injection. The medication circulates throughout the bloodstream and to all parts of the body to treat hot flashes, night sweats, and osteoporosis.

Non-systemic medications – these medicines are available in the form of cream, ring, or tablet to treat vaginal symptoms. They target a localized area of the body.

What are the benefits of HRT?

Hormone replacement therapy is particularly beneficial in treating various menopausal symptoms. Let’s have a look.

Reducing vasomotor symptoms – the most effective treatment for reducing vasomotor symptoms like hot flushes and night sweating, etc. A clear improvement has been observed in females within four weeks of starting the therapy and the maximum benefit is gained in three months.

Improving the quality of life – HRT improves the quality of life in symptomatic women by improving sleep, and reducing muscle aches and pains.

Improving mood swings – HRT improves your mood changes and is also beneficial for depression and anxiety.

Improving urinogenital symptoms – various studies have shown that HRT improves the sex drive and vaginal dryness. It also has a proliferative effect on the urinary bladder and urethral epithelium hence relieving the symptoms of urinary frequency.

Reducing the risk of osteoporosis – estrogens introduced via HRT are the most effective way of increasing bone mineral density (BMT) in menopausal women. It also prevents bone thinning and osteoporotic fractures.

Reducing the risk of cardiovascular disease – HRT reduces the risk of heart failure and heart attacks when started before 60 years of age.

Lowering the risk of colorectal cancer – various studies have shown that the risk of colorectal cancer has been significantly reduced by the use of combined estrogen-progesterone therapy.

Some other benefits of HRT are listed below:

  • Decreased tooth loss
  • Decreased osteoclastic resorption
  • Enhancement of muscle mass and strength in women
  • Lower risk of diabetes
  • Reduced mortality among young menopausal women in their 40s
  • Prevents aging of the skin
  • Increased skin collagen content, hydration, and thickness
  • Improves wound healing
  • Reduction in the diagnosis of Alzheimer’s disease
  • Stable migraine symptoms

What are the risks of HRT?

There are some serious risk factors associated with hormone replacement therapy that one should not ignore.

Thromboembolic disease – the type, dose, and delivery system of HRT elevate the risk of thromboembolic disease, especially venous thromboembolism (VTE). The risk of VTE is increased two to three times if the medication is taken orally.

Hypertension – hypertension or uncontrolled high blood pressure is another serious risk factor that can create havoc in your life. Talk to your doctor immediately if you have this problem so that an alternate solution can be suggested.

Stroke – there is a risk of ischemic stroke but not hemorrhagic. The effects of HRT on stroke are dose-related that’s why the lowest dose is prescribed to women who have significant risk factors for stroke.

Breast cancer – combined HRT may increase the risk of breast cancer as it increases the breast density. But some studies have failed to show the link between breast cancer and estrogen therapy alone.

Endometrial cancer – HRT with estrogen alone increases the risk of endometrial cancer in women with a uterus. To reduce the risk, progesterone is introduced along with estrogen.

What are the side effects of HRT?

Every therapy or medication comes with its own set of side effects. You must contact your doctor if you face any of these conditions

  • Breast tenderness
  • Swelling in the breasts or other parts of the body
  • Vaginal bleeding
  • Nausea
  • Bloating
  • Headaches
  • Migraines
  • Mood changes
  • Indigestion
  • Fluid retention
  • Mild depression or anxiety
  • Acne
  • Abdominal or back pain
  • Leg cramps

These symptoms disappear after a few weeks, still consulting your doctor is necessary.

Can HRT cause hair loss?

We all know that hormonal changes affect our hair growth and health. HRT is also a therapy in which hormones are used so you must be wondering, can HRT cause hair loss in women? Well, the answer is yes but not for everyone. Remember HRT is not a one-size-fits-all. Everybody reacts to the medication differently. Some suffer from hair loss; others do not. So let’s shed some light on how hormone therapy causes hair loss.

Sometimes doctors prescribe HRT with a combination of testosterone to improve a woman’s libido. Due to low libido, females often have less sexual desire or a much-reduced sex drive. To make them sexually active, testosterones are introduced which affects the hair follicles hence causing androgenic alopecia.

Not every woman with testosterone will have to deal with hair loss but hair loss can also be experienced by those who are just taking combined HRT or estrogen alone. In any case, you must consult your doctor about the factors that are causing hair loss.

If you’re facing severe hair loss then consult your doctor for possible solutions and if none of them turn out to be suitable then know that something like a modern-day women’s wig could be a way of masking your hair loss and regaining your confidence.

Hormone treatment therapy: Conclusion

Hormone treatment therapy is a standard approach to tackle several health concerns. Estrogen and progesterone in combination help manage various symptoms of menopause, however, not everyone reacts the same to the therapy. If you plan to undergo HRT then you must know the benefits and risks in detail to avoid any serious issues. One such risk is hair loss.