HRT is short for Hormone Replacement Therapy (sometimes referred to as MHT or Menopausal Hormone Therapy in the States/Canada).
HRT is a combination of estrogen, micronised progesterone, & testosterone. A woman makes all three of these hormones until she reaches perimenopause (on average in her mid-40’s, but can be earlier) when hormone production decreases steadily.
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Transdermal estrogen may be offered as a gel, spray or patch- this application through the skin carries less risks or clotting than oral estrogen.
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Vaginal estrogen is also incredibly important for vaginal and bladder health. It can be used by all women, even those who suffered breast cancer.
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Micronised Progesterone must also be taken to balance the estrogenic effect on thickening the womb- it protects against this. Progesterone can be taken as a pill before bed as it increases sleepiness and calm. Progestin, a synthetic form of progesterone may also be used in the form of Mirena IUD. This still protects the womb from thickening and ALSO prevents pregnancy in women who still get their period in the perimenopausal stage.
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Testosterone is still not licensed for HRT use in women in the UK & Ireland. So doctors use smaller amounts with careful testing for levels. Primarily prescribed for women with low libido.
Primarily, HRT is offered to support bone health and hot flashes. While studies remain to be done, HRT was shown to be beneficial for many other symptoms of menopause including but not limited to low mood, joint pain, anxiety, heart palpitations and sleeplessness.
HRT does NOT cause breast cancer. This misconception was due to an erroneously interpreted World Health Initiative study. The initial interpretation of the Women’s Health Initiative (WHI) study in 2002 overstated the risks of hormone replacement therapy (HRT), especially concerning breast cancer. Early reports did not distinguish adequately between different types of HRT or the age and health status of participants. Later analyses revealed that for many women, particularly those under 60 or within 10 years of menopause onset, the benefits of HRT may outweigh the risks. The fear generated by the misinterpretation led to a sharp decline in HRT use and confusion among patients and providers.
