Hormone replacement therapy

Hormone replacement therapy is medication that contains female hormones. Medication to replace the oestrogen that our body stops making during menopause. Hormone therapy is most often used to  treat common menopausal symptoms, including hot flashes and vaginal discomfort. Hormone therapy has also been proved to prevent bone loss and reduce fracture in postmenopausal women.

Oestrogen therapy

Oestrogen is taken alone. Doctors most often prescribe a low dose of oestrogen to be taken as a pill or  patch every day. Oestrogen may also be prescribed as a cream, vaginal ring, gel or spray. You should  take the lowest dose of oestrogen needed to relieve menopause symptoms and/or to prevent osteoporosis.

Oestrogen Progesterone/Progestin Hormone Therapy (EPT)

Also called combination therapy, this form of HT combines doses of oestrogen and progesterone (or progestin, a synthetic form of progesterone). In Combination EPT Pills and patches are used.

Hormone replacement therapy primarily focuses on replacing the oestrogen that your body no longer  makes after menopause. There are two main types of estrogen therapy:

• Systemic oestrogen — which comes in pill, skin patch, ring, gel, cream or spray form — typically contains a higher dose of oestrogen that is absorbed throughout the body. It can be used to treat any of the common symptoms of menopause.

• Low-dose vaginal preparations of oestrogen — which come in cream, tablet or ring form —  minimize the amount of oestrogen absorbed by the body. Because of this, low-dose vaginal preparations are usually only used to treat the vaginal and urinary symptoms of menopause.

In the largest clinical trial to date, hormone replacement therapy that consisted of an oestrogen progestin pill (Prempro) increased the risk of certain serious conditions, including:

• Heart disease 
• Stroke 
• Blood clots 
• Breast cancer 

Subsequent studies have suggested that these risks vary depending on:

Age:

Women who begin hormone therapy at age 60 or older or more than 10 years from the onset of menopause are at greater risk of the above conditions.

Type of hormone therapy:

The risks of hormone therapy vary depending on whether oestrogen is given alone or with progestin, and on the dose and type of estrogen.

Health history:

Your family history and your personal medical history and risk of cancer, heart disease, stroke, blood clots, liver disease and osteoporosis are important factors in determining whether hormone replacement therapy is appropriate for you.

You may be able to manage menopausal hot flashes with healthy-lifestyle approaches such as keeping cool, limiting caffeinated beverages and alcohol, and practicing paced relaxed breathing or other relaxation techniques. There are also several nonhormone prescription medications that may  help relieve hot flashes.

Hormone therapy, specifically oestrogen therapy, has been studied for its potential benefits in cognitive regeneration after menopause. Here are some ways in which hormone therapy may have positive effects on cognitive function:

Memory and attention: 

Oestrogen has been shown to play a role in memory and attention processes. Hormone therapy, particularly when initiated early after menopause, may help improve memory and attention span in some women.

Brain structure and function: 

Oestrogen promotes the growth and survival of neurons, enhances synaptic connectivity, and improves cerebral blood flow.

Prevention of cognitive decline: 

Hormone therapy, especially when started closer to the onset of menopause, may help reduce the risk of cognitive decline and dementia later in life.

Have moderate to severe hot flashes. Systemic oestrogen therapy remains the most effective treatment for the relief of troublesome menopausal hot flashes and night sweats.

Oestrogen can ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse. Systemic oestrogen helps protect against the bone-thinning disease called  osteoporosis.

Oestrogen therapy can help decrease your risk of certain health conditions, including osteoporosis, heart disease, stroke, dementia and mood changes.