Hormone Replacement Therapy
If you’re looking for relief from menopause symptoms, Dr. Helva has the expertise to help you decide whether hormone replacement is right for you. We can help you weigh the pros and cons and suggest choices based on the severity of your symptoms and your medical history.
What Is Hormone Replacement Therapy?
During menopause, your estrogen levels fall. Some women get uncomfortable symptoms like hot flashes and vaginal dryness. HRT (also known as hormone therapy, menopausal hormone therapy, and estrogen replacement therapy) is the most effective treatment for menopause symptoms.
Doctors generally suggest a low dose of estrogen for women who have had a hysterectomy, the surgery to remove the uterus, and for women who've had a bilateral oophorectomy (the surgical removal of the uterus and ovaries). Estrogen comes in different forms. The daily pill and patch are the most popular, but the hormone also is available in a vaginal ring, gel, or spray.
Estrogen pill — Pills are the most common treatment for menopausal symptoms. Among the many forms of pills available are conjugated estrogens. Most estrogen pills are taken once a day without food. Some have more complicated dosing schedules. As noted above, estradiol is the same estrogen that the ovary makes before menopause.
Estrogen patch — The patch is worn on the skin of your abdomen. Depending on the dose, some patches are replaced every few days, while others can be worn for a week. Combination estrogen and progestin patches are also available.
Topical Estrogen – Creams, gels and sprays offer other ways of getting estrogen into your system. As with patches, this type of estrogen treatment is absorbed through the skin directly into the bloodstream. The specifics on how to apply these creams vary, although they're usually used once a day.
Vaginal estrogen — Vaginal estrogen comes in a cream, vaginal ring, or vaginal estrogen tablets. In general, these treatments are for women who are troubled specifically by vaginal dryness, itchiness, and burning or pain during intercourse. Dosing schedules vary, depending on the product. Most vaginal rings need to be replaced every three months. Vaginal tablets are often used daily for a couple of weeks; after that, you only need to use them twice a week. Creams might be used daily, several times a week, or according to a different schedule.
Estrogen/Progesterone/Progestin Hormone Therapy
This is often called combination therapy, since it combines doses of estrogen and progestin, the synthetic form of progesterone. It’s meant for women who still have their uterus. Taking estrogen with progesterone lowers your risk for cancer of the endometrium, the lining of the uterus.
While generally used as a form of birth control. Progesterone can help treat many menopausal symptoms such as hot flashes.
Oral progestins – Taken in pill form, progestin medications are used to treat menopausal patients with natural progesterone rather than synthetic progestins. Natural progesterone has no negative effect on lipids and is a good choice for women with high cholesterol levels. In addition, natural progesterone might have other advantages when compared with medroxyprogesterone acetate.