Menopause is something that many women experience when they are 45-50 years old. Suddenly, you start sweating, you can't sleep at night, you get angry at small things, you feel like you're not okay... Are these things familiar to you? Although many people suffer from this, thinking it's just a part of life, there are good treatments to control these annoying symptoms. Today we are talking about one of the main treatments, hormone therapy.
What is hormone replacement therapy (HRT)?
Simply put, when you reach menopause, your ovaries stop producing a hormone called estrogen. When this hormone, which controls many things in your body, decreases, those annoying symptoms mentioned above appear. So, hormone replacement therapy (HRT) works by giving your body the hormones it has lost. Once these hormone levels return to normal, many of those symptoms go away.
Doctors sometimes call this Hormone Therapy (HT). There's not much difference, but usually when this treatment is taken at a young age, perhaps before the age of 40, the term HRT is used more often. Because what happens there is that the body is 'replacing' the hormones that it should be producing naturally.
Whether this treatment is right for you or not is a decision that should be made in consultation with your doctor. As it has its benefits, it can also carry some risks. So, let's take a closer look at this.
Do you also have these symptoms during menopause?
The main symptoms that can be relieved by hormone therapy are:
- Hot flashes: Sudden feeling of heat and sweating.
- Night sweats: Waking up at night sweating.
- Vaginal dryness: Vaginal dryness makes intercourse painful.
- Mood swings: Frequent changes in mood such as happiness, sadness, and anger.
- Insomnia: Problems sleeping at night.
- Leaking pee: A small amount of urine leaks out when you cough or laugh.
In addition, this treatment also helps prevent osteoporosis , a bone thinning disease that is commonly caused by a decrease in the hormone estrogen.
What are the types of hormone treatments?
There are two main types of hormone therapy. Your doctor will decide which is best for you based on your symptoms, health history, and your preferences.
| Type of treatment | Description and who is suitable? |
|---|---|
| Estrogen-only therapy | This only gives the hormone estrogen. It is usually prescribed to women who have had their uterus surgically removed (hysterectomy). Because they do not have a uterus, they do not have the risk of uterine cancer that can occur with estrogen alone. |
| Combination therapy with estrogen and progestin | In this, along with the estrogen hormone, a hormone called progestin, which acts like progesterone, is also given. This is given to women who still have a uterus to prevent the walls of the uterus from thickening unnecessarily and increasing the risk of cancer if estrogen alone is taken. Progestin reduces that risk. |
How do you get this treatment?
There are several ways to deliver these hormones to the body.
- Swallowed pills
- Skin patch
- Gel applied to the skin
- A ring worn in the vagina
- Vaginal cream or dissolving tablet
- Spray for the skin of the hands
These can also be divided into two parts depending on how they are delivered:
1. Systemic treatments: In these methods (pills, patches, gels, sprays), hormones are absorbed into the bloodstream and travel throughout the body. These work well for many common symptoms, such as hot flashes and night sweats.
2. Local treatments: In these methods (vaginal creams, rings, tablets), hormones are applied only to the affected area. These are best suited for problems such as vaginal dryness. Here, the dose of hormones entering the body is very low.
What are the benefits and risks of the treatment?
Like any medical treatment, HRT has both benefits and risks. The most important thing is to talk to your doctor and understand whether the benefits outweigh the risks, based on your situation.
| ✅ Benefits | ⚠️ Risks |
|---|---|
| Relief of symptoms such as hot flashes and night sweats. | If people with a uterus take estrogen alone without progestin, they are at risk of uterine cancer . |
| Vaginal dryness and painful intercourse. | Starting 10 years after menopause may increase the risk of heart disease . |
| Strengthening bones and reducing the risk of osteoporosis . | Slightly increased risk of blood clots and stroke . |
| Improved mood and sleep. | Risk of gallbladder disease . |
| Reduced risk of colon cancer and diabetes for some people. | Some people may have a slightly increased risk of breast cancer when taken for a long time (more than 5 years). |
Important: These risks depend on many factors, such as your family history of diseases and your lifestyle. So talk to your doctor before you panic.
How to reduce the risk?
The best thing is that there are ways to minimize these risks.
- Starting treatment before the age of 60 or within 10 years of menopause.
- If you have a uterus, you should definitely take a treatment that contains progestin .
- You can start with the lowest effective dose .
- Living a healthy lifestyle (exercising, eating healthy).
- Get gynecological check-ups and mammograms done on time .
Who should not take hormone therapy?
Hormone therapy may not be suitable for people with certain health conditions. For example:
- Those who have had or currently have breast, ovarian, or uterine cancer.
- For those with unusual vaginal bleeding for no known reason.
- For those with blood clotting disorders or high risk.
- For those who have had a stroke, heart attack or are at high risk for it.
- For pregnant women.
- For those with liver or gallbladder disease.
Are there any side effects? What to do about them?
Some side effects may occur at the beginning of treatment, but most of these go away within a few months.
- Irregular light bleeding.
- Breast pain or tenderness.
- Change in mood.
- Things like bloating, headaches.
If this is a concern for you, talk to your doctor. He or she may be able to change the dose or type of medication you take. Never stop taking your medication or change the dose without talking to your doctor first.
Take-Home Message
- Menopause can be a difficult time, but you don't have to suffer with the symptoms. They can be managed.
- Hormone replacement therapy (HRT) is a very effective solution, but it is not suitable for everyone.
- Before starting treatment, it is important to discuss the benefits and risks with your doctor and make a decision that is specific to you.
- This treatment usually lasts about 5 years, but that time can vary depending on your needs.
- It is very important to maintain a healthy lifestyle and undergo regular medical checkups while taking HRT.
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