Hormone Replacement Therapy (PDF)

Hormone Replacement Therapy

What is Hormone Replacement Therapy (HRT)?

HRT uses hormones that are not made by your body to help relieve symptoms of menopause, including hot flashes, night sweats, and vaginal dryness. HRT can also help decrease bone loss and decrease the risk of osteoporosis in postmenopausal women.

What are the risks of HRT?

* Endometrial cancer risk increases in women with a uterus if estrogen is given without progesterone.
* In postmenopausal women, taking HRT can mildly increase the risk of heart attacks, strokes, blood clots, and breast cancer; this can depend on your age and if you are using just estrogen or both estrogen and progesterone. This risk increases the longer a woman takes HRT after she turns 50. To reduce your risk, take the lowest dose of HRT that is effective for you, for the shortest amount of time.

What are Bioidentical hormones?

Bioidentical hormones begin as soy products or wild yam, which are then converted to different hormones in a laboratory. These hormones are the same hormones that your body makes, though not in the same proportions, combinations, or strengths. The term “bioidentical” does not mean “natural” or “not synthetic.” There are some FDA approved forms of bioidentical hormones, as well as hormones created by a compounding pharmacy are not controlled by the FDA.

What should I know about compounded bioidentical hormone replacement?

* Bioidentical hormones are not risk free. Currently, there are not any medical studies confirming the risks and benefits of bioidentical hormones, and therefore, the risk should be assumed to be the same as with traditional HRT.
* Bioidentical hormones made by compounding pharmacies are not regulated or monitored by the FDA. The pharmacy must then regulate the purity and potency of the hormones in these compounds. Also, it is possible the dosage with vary each time the prescription is refilled since a new “batch” is made each time.
* The safety and efficacy of these compounds are not as directly determined as FDA approved drugs.
* Bioidentical hormones often cost significantly more than traditional HRT.

What is salivary testing and should I have it done?

Salivary hormone testing can be done to test the levels of sex hormones in your saliva. There is no evidence that there is a reliable link between the hormone levels in saliva testing and the hormone levels in your body. Salivary hormone concentrations can also be changed depending on diet, time of day of testing, and other variables.

What other options are there to HRT?

* SSRI or SSNI medications, that were originally designed as antidepressants – These medications can help with hot flashes and, if necessary, some mood problems that occur with menopause.
* Herbal products – Soy products may help to relieve hot flashes and vaginal dryness. Black cohosh may help reduce hot flashes. Notify your provider before you start taking any herbal supplements as they can interact with prescription medications.
* Vaginal lubricants can help with vaginal dryness during sex
* Prescription vaginal estrogen products can help with vaginal thinning, pain, and dryness with intercourse

Written by the Women’s Group Practitioners Last Reviewed in November 2009
© Copyright 2009 The Women’s Group PC 1