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Hormone Replacement Therapy

Description

Several drugs can be prescribed to help with menopause-related changes. By far, the most often prescribed drugs are hormones, to replace those produced in gradually lower levels throughout perimenopause and beyond. The main types of hormone replacement therapy are:

  1. Oestrogen replacement therapy (ERT)
  2. Hormone Replacement Therapy (Oestrogen plus Progestogen)
  3. Testosterone

1. Oestrogen replacement therapy (ERT) is unique in that it offers the potential for help with a wide range of both short-term disturbances and prevention of major diseases such as heart disease, osteoporosis and, possibly, Alzheimer's disease. The benefits of ERT for women at particular risk for osteoporosis and/or heart disease are best achieved if therapy is begun at menopause and continued indefinitely. There are also many types of oestrogen that are called ERT. Potential side effects of ERT include:

  • Vaginal bleeding (starting or returning).
  • Breast tenderness.
  • Nausea.
  • Fluid retention (bloating).
  • Changes in the shape of the eye (sometimes leading to contact lens intolerance).
  • Headache (sometimes migraine).
  • Dizziness.
  • Depression.
  • Reduced tolerance to sugar and other carbohydrates.
  • Increased incidence of gallbladder disease.
  • Uterine cancer risk. Taking oestrogen alone for 5 or more years can triple the risk of endometrial (uterine) cancer. Fortunately, progestogen makes that risk extremely small.
  • Breast cancer risk. The relationship between ERT and breast cancer remains a controversial issue.

2. Hormone Replacement Therapy (Oestrogen plus Progestogen) . When a woman with a uterus chooses to take ERT, the natural progesterone that the ovaries once produced must be replaced to help counteract the increased risk of uterine cancer from taking ERT alone. Proper doses of prescription progestogen help keep the endometrium from thickening and developing into cancer. When taking progestogen with ERT, the risk of endometrial cancer is substantially reduced, almost to the level of taking no hormones at all. Taking a combination of oestrogen and progestogen is called "hormone replacement therapy" (HRT).
Some women may have the following side effects with synthetic progestin use:

  • Fluid retention
  • Headache
  • Breast tenderness
  • Alterations in mood

These side effects that are possible when taking synthetic progestins may be substantially reduced with the use of natural progesterone.

3. Testosterone . Although research findings are conflicting regarding oestrogen's ability to improve women's sex drive, another hormone - testosterone (an androgen) - appears to play an important role. Often thought of as a "male" sex hormone, testosterone is secreted by the ovaries and is therefore natural to the female body. Surgical menopause (removal of the ovaries before natural menopause) may have a negative effect on sex drive. Testosterone therapy is sometimes prescribed to help.

For further, more detailed information on this topic, please refer to the reference source for this page.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The North American Menopause Society: http://www.menopause.org/


Other HON resources 
   From MedHunt
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Hormone replacement therapy
Oestrogen replacement therapy
Progesterone replacement therapy
 

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  http://www.hon.ch/Dossier/MotherChild/female_repro/menopause_hrt.html Last modified: Jun 25 2002