HORMONE REPLACEMENT THERAPY, ALSO KNOWN AS HRT , REFERS TO THE USE OF MEDICATIONS TO PROVIDE A
woman with the female hormones that she no longer produces. When a woman reaches menopause – which happens most frequently around 50 – she naturally begins to produce less female hormones (such as oestrogen and progesterone) which in turn leads to her experiencing hot flushes, night sweats, disturbed sleep and vaginal dryness. Some may also experience changes in their emotions such as frequent irritability and mood swings, while others may experience depression, anxiety, fatigue, memory lapses and other such psychological symptoms.
Symptoms of menopause
HRT used to be the standard treatment for menopause and its symptoms, which tend to be at their worst during the two to three years leading up to actual menopause. For some patients, these symptoms can be so bad that they negatively affect her ability to lead their lives; vaginal dryness, for instance, can often lead to pain during sexual intercourse as well as interfere with normal urination, while the inability to sleep peacefully has obvious psychological and physiological ramifications.
HRT also protects against some of the long-term effects of menopause such as osteoporosis and was thought to have other health benefits. This view was however changed abruptly in 2002 when a controversial clinical study found that one form of HRT , if not administered carefully, may actually do more harm than good, particularly when given to older postmenopausal women. Nonetheless, recent reviews of clinical studies and new evidence show that hormone therapy remains a good choice for most women provided they are carefully evaluated before beginning the treatment: this is why it is important to always speak to your gynaecologist if you are considering undergoing HRT .
The treatment can be started either in the menopausal years or after a premature menopause in women under 40 years. It is also frequently administered following hysterectomy (the surgical removal of one’s womb) and bilateral salpingo-oophorectomy (the surgical removal of one’s fallopian tubes and ovaries) as these procedures also interfere with the body’s ability to produce and regulate female hormones. There are two ways in which HRT are frequently administered. The most common form, systemic hormones, are often administered as pills, skin patches, gels or creams and are the most effective treatment for the relief of troublesome menopausal hot flashes and night sweats. Vaginal hormones, on the other hand, are low-dose preparations of oestrogen that are absorbed in the vagina through tablets, creams or vaginal rings and are used to treat vaginal and urinary symptoms.
Quality of life
HRT needs to be taken on a regular basis, and it takes time for the effects of the treatment to be seen; one should not expect overnight miracles. Given enough time, however, most women will most definitely see a distinctive improvement in their quality of life through the application of HRT.
Dr Kelly Loi Consultant Obstetrician & Gynaecologist