The troubles caused by menopause? Let's learn about hormone therapy in simple terms.

As soon as you hit the age of 45 or 50, you suddenly start sweating, you can't sleep well at night, you get angry over small things, you feel bad... Are these things familiar to you? These are the common symptoms that many women experience during menopause. We know that this time is very difficult. Although many people suffer from these things in silence, there are actually good solutions to this. One of the most important and successful of those solutions is hormone therapy. Let's talk about this very simply, as if we were talking to a close friend.

What is hormone replacement therapy (HRT)?

Simply put, it's very simple. Hormone Replacement Therapy (HRT) is the process of externally replacing the hormones (especially estrogen) that your body stops producing with menopause.

Think of it this way: your body is like a factory with all sorts of machines. Estrogen is like the chief engineer working in it. When she retires (that is, when you go through menopause), the factory goes a little crazy. At that time, we bring in another engineer from outside and get things back on track. Hormone therapy is something like that.

This decrease in hormone levels is what causes you to experience these problems:

• Hot flashes: Sudden heat and sweating in the face, neck, and chest.
• Night sweats: Waking up at night with your body drenched in sweat.
• Vaginal dryness and painful intercourse: This is something that many people are embarrassed to talk about, but it is common.
• Changes in mood: feeling angry for no reason, feeling sad, feeling anxious.
• Insomnia: The inability to sleep at night.
• Frequent urination: A small amount of urine may leak out during times like sneezing or laughing.

Hormone therapy works by restoring the lost hormones to your body and restoring your hormone levels to some extent. This will help to alleviate many of the symptoms mentioned above. It can also help to protect against osteoporosis, a bone thinning disease that occurs when estrogen levels drop.

Are HRT and HT two different things?

When you go to see a doctor, you may hear both of these terms. Hormone Replacement Therapy (HRT) and Hormone Therapy (HT). There really isn't much difference between the two. Generally,

• Hormone Therapy (HT): The term can be used for any hormone treatment. This name is also used for things like hormone therapy for cancer, treatments for other hormone imbalances, etc. This name is also used for treatments for menopause.
• Hormone Replacement Therapy (HRT): This term is used specifically to refer to the process of "replacing" hormones that the body has stopped producing naturally. This term is most often used for treatments given to someone who is going through menopause, especially before the age of 40.

However, the most important thing for you is to understand that both of these things are about managing menopause symptoms.

There are two main types of hormone therapy:

Your doctor will choose the treatment that best suits you based on your symptoms, health history, and your preferences. There are two main types.

1. Estrogen therapy

This is where you are given only the hormone estrogen . This treatment is usually recommended for women who have had their uterus removed (hysterectomy) because the long-term risks of taking estrogen alone are lower for someone without a uterus.

This estrogen treatment can be taken in various ways:

• Swallowed pills
• A patch
• A skin-soothing gel
• A ring worn in the vagina
• A cream applied to the vagina
• Vaginal tablets
• A spray that is applied to the skin of the hand.

2. Combination therapy (estrogen and progesterone)

This treatment gives you both the hormones estrogen and progesterone . All women who have not had their uterus removed must take progesterone (or a progestin that works similarly) along with estrogen.

This combination treatment usually comes in the form of pills or a skin patch. Sometimes progesterone can also be given through an intrauterine device (IUD) placed inside the vagina.

Treatment methods: Systemic and Local

These treatments can be further divided into two categories based on how they affect the body. Once you understand this, it's easier to choose what's right for you.

What are the benefits of taking hormone replacement therapy (HRT)?

The main benefit of this treatment is that it provides relief from the bothersome symptoms of menopause, which greatly improves your quality of life.

• The main symptoms disappear: things like hot flashes, night sweats, and vaginal dryness almost completely disappear.
• Strengthens bones: When estrogen levels decrease, the risk of osteoporosis increases. HRT significantly reduces this risk.
• Feeling better: Some women find that this treatment improves their mood and makes them feel happier about life.
• Sleep better: When night sweats stop, sleep is uninterrupted.
• Other benefits: Some studies have shown that combination therapy can also reduce the risk of colon cancer and diabetes.

But there are some risks involved.

Like any treatment, HRT has some risks. Before you get too scared about these, it's important to understand that these risks are not the same for everyone.

Some possible risks:

• Uterine cancer: This only happens if someone with a uterus takes estrogen alone. This risk disappears when taken with progesterone.
• Blood clots and stroke: This risk is slightly higher, especially when taken as a pill. This risk is lower when used as a skin patch.
• Gallbladder disease: The risk of developing gallstones may be slightly increased.
• Breast cancer: Some studies show that taking combination therapy for a long time (more than 5 years) may slightly increase the risk of breast cancer. However, this increase is very small.
• Heart disease: Starting HRT after 10 years of menopause, which is after age 60, may increase the risk of heart disease. However, this risk is almost non-existent for those who start HRT as soon as menopause begins (in their 50s).

How can the risk be reduced?

• Start treatment before age 60 or within 10 years of menopause.
• If you have a uterus, definitely take progesterone.
• Talk to your doctor to choose the treatment method and dosage that best suits you. (For example, a patch instead of pills)
• Live a healthy lifestyle (exercise regularly, eat a balanced diet, and control your weight)
• Get gynecological exams and mammograms at the scheduled time.

Who is this treatment not suitable for?

Doctors do not recommend HRT for people with certain health conditions because the risks outweigh the benefits.

• If you have or have had breast cancer, ovarian cancer, or uterine cancer
• If you have vaginal bleeding of unknown cause
• If you have had blood clots in the past or are at increased risk for them
• If you have had a stroke or heart attack
• If pregnant
• If you have liver or gallbladder disease

What are the possible side effects?

There may be minor side effects at the beginning of treatment, but these usually go away after a few months as the body gets used to it.

Common side effects:

• Irregular light bleeding (spotting)
• Breast pain or tenderness
• Mood swings

Less common side effects:

• Bloating
• Headache
• Skin discoloration
• Increased breast density (this can make mammograms a little harder to read)
• Itching or redness of the skin where the patch is applied

Are there alternatives to HRT?

Yes, absolutely. If you can't take HRT, or don't like it, there are other ways to manage your symptoms. Talk to your doctor about these.

• For vaginal dryness: Lubricants available at the pharmacy.
• For burning sensation: Some antidepressants are used in low doses.
• Other medications: Medications given for other conditions, such as `(Gabapentin)` and `(Clonidine),` also help with menopausal symptoms.
• SERMs (Selective estrogen receptor modulators): These are drugs that act like estrogen, but only affect certain parts of the body.

Menopause, hormone therapy, HRT, menopause, estrogen, progesterone, women's health