What is hormone replacement therapy (HRT)?

Hormone replacement therapy (HRT) can help reduce night sweats, hot flashes, and other symptoms of menopause. It may also reduce the risk of osteoporosis. Some types of HRT contain both progesterone and estrogen, some have only estrogen, and sometimes testosterone is also used. Hormone replacement therapy is also used in male hormone therapy and treatment for people undergoing sex change.

Hormone replacement therapy (HRT) is also known as menopausal hormone therapy (MHT) or postmenopausal hormone therapy (PHT, PMHT). This therapy is used to treat symptoms that occur during perimenopause and menopause in women. These symptoms include atrophy, vaginal dryness; bleeding; bone loss and a few other symptoms. The main cause of these symptoms is the drop in sex hormone levels during menopause.
The main hormonal drugs used in HRT are estrogen and progestogen. Progestogens are often used with estrogen for women who have not had a hysterectomy, called "combined hormone replacement therapy" or simply "hormone therapy." Estrogen alone (without progesterone) is associated with endometrial hyperplasia and uterine cancer, and oral progestogen reduces these risks.

The hormone estrogen is taken in many different forms, including pills, patches, gels, or sprays, all of which have the same purpose of providing a steady supply of estrogen to the body in a given dose. certain.
With this therapy, estrogen will be released into the bloodstream and then delivered to the tissues and organs in need, however, it only releases a small amount of estrogen and the tissues of the vagina. Vaginal dryness can be treated with topical hormone therapy in the form of tablets, vaginal rings, or creams.
For oral tablets, the course for each month is usually from the first day to the 14th day of the menstrual cycle will take estrogen pills, and for the next 10 days will take progestogen pills. The remaining days of the period will stop the drug completely, about 1 week. The effect of using the drug can cause vaginal bleeding, but not a natural period, the amount of bleeding is lighter in color and less than a normal period, this will last for 2-3 days. day. However, if vaginal bleeding occurs abnormally like heavy bleeding and lasts a day, you need to see a specialist for early treatment.
When using the patch on the skin, the estrogen in the patch will be released gradually into the bloodstream without going through the liver. Patients will be given oral progesterone when using the patch.
Besides, you can also use the implant form under the skin. It has the ability to gradually release a steady amount of estrogen into the bloodstream, but you need to re-implant it after a few months and it will cost more than the oral pill form.
To treat symptoms such as vaginal dryness, you can use a cream that is applied directly to the vagina. The drug will penetrate the skin and quickly enter the bloodstream. However, this measure is usually only used for a short time.
It should be noted that taking a combination of several estrogen-containing drugs at the same time will lead to an overdose and cause unwanted side effects, such as pain, breast tenderness, abdominal distension, nausea, weight gain. When the above symptoms appear, it is best to see your doctor for advice on reducing the dose.
Because each person will have a dose response to estrogen, so you should listen to your doctor's advice and strictly follow the prescription. In addition, you should also monitor regularly, if something unusual happens, immediately contact your doctor to receive other treatment solutions. In addition, you must not share prescriptions with others to avoid possible undesirable consequences.

In some cases, hormone replacement therapy cannot be used because it may carry other risks, including an increased chance of cancer or cancer recurrence, and abnormal blood clotting. The following are specific situations where hormone replacement therapy (HRT) is not indicated :
People with thromboembolic disease Heavy smokers People with high blood pressure People with severe kidney or liver disease People with gallbladder disease People with breast or endometrial malignancies People with otosclerosis People in the family with a grandmother, mother, sister or brother with breast cancer, cervical cancer People with negative bleeding Unexplained pathology Pregnant women Cerebrovascular accident Diabetic lupus erythematosus

Studies have shown that systemic estrogen therapy (with or without progestin) is the most effective treatment for hot flashes and night sweats. In addition, estrogen supplement therapy also helps to reduce vasomotor symptoms, reverse aging, reduce symptoms of genital atrophy, is very good for the skeletal system, prevents and reduces the phenomenon of spongy, bone loss, reducing the rate of fracture. It is also very beneficial for the cardiovascular system and improves the condition of atherosclerosis. In addition, estrogen supplements also help increase sex drive, enhance memory, increase brain perfusion and reduce the risk of Alzheimer's disease.

In fact, hormone replacement therapy cannot provide and respond to the full amount of estrogen for women before menopause, because it only introduces a small amount of estrogen into the body. On the other hand, hormone replacement therapy also has many risks if not used correctly. Harmful effects of estrogen treatment include:
Increased risk of heart attack. This risk is related to age, existing medical conditions, and when a person starts taking hormone replacement therapy. Combination hormone therapy and estrogen-only therapy increase the risk of stroke and deep vein thrombosis (DVT). Combination hormone therapy also increases the risk of breast cancer. Hormone therapy with or without progestin poses a higher risk of gallbladder disease.

Articles source references: Cancer.gov, Medicalnewstoday.com