Around 50 million women in menopause in the US report hot flushes in the nights, that is sometimes accompanied by heavy sweating. Various symptoms and effects of this disrupt routine and cause acute discomfort to women in this age group. Effects such as impact on sleep and dry vagina severely affect women. A majority of these effects are attributed to vasomotor symptoms; that occur as a result of either constriction or dilation of blood vessels. Various medications and therapies are intended to help women cope with the outcome of the cessation of menstruation, and this includes replacement of hormones. This is regarded as an effective option to help manage the natural process of menopause. Subsequent sections will offer detailed information on hormone replacement therapy side effects to help avoid or mitigate undesirable consequences.

Why is hormone therapy replacement a better option?

As mentioned above, there are various medications to help women cope with menopause related conditions. However, HRT is regarded as an effective option, mainly because the therapy extends relief to various symptoms. This is in contrast to other options that offer relief only to a single symptom. In other words, women who contend with many effects of menopause may end up having to take multiple medications to therapies to handle different symptoms, if HRT is not considered.

What is HRT and how does it help manage menopause related conditions?

Women in menopause experience various symptoms or conditions mainly as a result of lowered hormone levels. This is a natural process of aging, wherein the hormone levels gradually reduce, bring to a halt various functions and processes associated with adult life in its prime. HRT refers to the replacement of hormones, wherein the hormones balance or settle as a result of the therapy. Estrogen levels deplete or reduce in the body during menopause, and HRT helps restore the balance gradually, and this may take around 6 weeks to 12 weeks. HRT, depending on the type of therapy may also replace progesterone, that is linked to the lining of the uterus. Various stages are linked to menopause such as:

HRT is typically intended to help women in post-menopausal stage by replacing the reduced hormones.

Why HRT is not suitable for all women?

While it is effectively a good choice to help women in post-menopausal stage, the therapy is not suitable for certain categories of women, as listed below:

The therapy is always to be administered in smaller dosages, that is necessary for the medication to offer relief. It is also necessary to limit the duration of the therapy to a short duration. In other words, the duration of the therapy should extend to only that length that is considered as necessary for offering relief from symptoms linked to post-menopause stage.

Why it is important for women to choose therapy

As much as 85% of women in post-menopausal stage undergo various symptoms that affect or disrupt normal life. For instance, hot flushes, heavy night sweating, unusual changes in mood, dry vagina and various other conditions have an impact on normal life. This also affects libido or the interest to indulge in sexual intercourse.  Another condition that is related to post-menopause is the risk of thinning of the bones. This may end up causing possible fractures in women; and many are known to frequently suffer from osteoporosis. This may occur even when women are not in circumstances or perform physical activities that may result in fractures.

Post-menopausal symptoms in most cases are not usually lifelong in nature, and may resolve after many years. However, certain conditions or outcomes of certain conditions are irreversible, such as thinning of the bones. Regardless of the natural process of restoration of the conditions, women are subject to acute discomfort during this period. It severely compromises the ability to of women in menopause live normal lives.

HRT is an effective option to help women experiencing the effects of menopause, and by virtue of being effective in mitigating various symptoms, it is probably the ideal option.

Are there other differences within replacement therapies?

HRT is of different types and the actual choice of therapy is determined by the hormone that needs to be replaced or restored. Options include combination therapy delivering oestrogen and progestogen, and estrogen only therapy. The latter option is for women without a womb. This could be either because of hysterectomy or medical conditions wherein women do not have a womb. This is an extremely rare condition that afflicts a very small percentage of women.

Therapy is extended in various forms such as:

Treatment is typically in cycles, wherein progestogen is taken intermittently. Whereas estrogen is taken without breaks and for a relatively longer period.  The most suitable therapy, duration and form is determined after suitable tests by a specialist.

Tablets are convenient

Tablets are taken once every day and are regarded to be one of the most convenient options. Tablets are available in both formulations – estrogen only and combined HRT. One of the reasons for tablets to be regarded as a preferred choice is the ability to avoid messy topical applications that affect routines in some manner. The downside to tablets in HRT is the relatively higher level of risk as it could lead to blood clots formation.

Next best option – skin patch

The next option in terms of preference are skin patches, that are also regarded as convenient. The patches can be worn for a few days, and then replaced. Available in both formulations – combined HRT and estrogen only formulations, skin patches have a few advantages. For instance, women may not experience indigestion experienced at times by women with HRT tablets. As mentioned earlier, tablets come with higher risk of blood clot formation, and skin patches are a better choice with lower risk in this aspect.

Common option – gel

estrogen gel is another common and preferred option among women looking for HRT treatment. Applied once every day, gels are free from the risk of blood clots formation; additionally, as the gel is not as visible as patches, women find this option relatively better. The downside of gel, is the formulation availability. It comes only in estrogen only formulations, and consequently, women may need to pick another option for the progestogen requirement. Many women are known to choose a combination option of estrogen gel and other forms of progestogen for relief.

HRT implants

Hormone replacement therapy implants are designed to release estrogen at periodic intervals. This helps women receive the required therapeutic levels of hormone infusion for months. The implants may then have to be replaced as required. The procedure involves the use of small pellet shape implants that are inserted underneath the skin on the stomach; and the procedure is carried out under local anesthesia. The advantage of this option is the ability to dispense with regular intake of medications, or applications of patches and gels.  In other words, women can get back to routine without additional daily actions.

One of the disadvantages of implants is the oestrogen only form, which makes it necessary for women to choose an additional option for progestogen requirements. This is because of the nature of the therapies. For instance, progestogen is intended to be taken only intermittently, while oestrogen needs to be taken frequently. This makes oestrogen the ideal candidate for implant and release.

Vaginal oestrogen

Vaginal cream or pessary or rings in the vagina are other options that are available for HRT. The highlight of these options is the ability to help women get back to near normal sexual activity. This is because of the relief from vaginal dryness, that affects interest in sex among women in menopause. Vaginal oestrogen is effective for managing this symptom but may not be effective in managing hot flushes. This option is chosen only when vaginal dryness needs to be treated effectively. Another advantage of this option is the safety dimension, as this is regarded as safe, and does not pose a risk of breast cancer to women.

Limited use of testosterone gel

Among the various options available, testosterone gel is regarded as an option with limited use, and is generally not considered as linked to menopause symptoms. The purpose of the gel is to increase the interest in sex among women and does not help manage any of the other symptoms. It is mainly used as a part of holistic therapy for women in menopause. While other options in combination therapy may focus on relieving symptoms, the gel is targeted at enhancing sex drive.

Undesirable effects of therapy in different forms 

The possibility of hormone replacement therapy side effects exists, and this extends to all women in menopause opting for one of the many options in HRT. Probably, the biggest risk is the possibility of breast cancer exposure, and it is therefore necessary to be screened, in addition to choosing an option that poses the least risk. Most undesirable effects resolve naturally after the therapy runs for a few months. Lingering effects are experienced only in certain instances; that may require some kind of intervention. Effects that last for a short period include headaches and possible tenderness in the breast. Other effects include feeling sick at times and indigestion. The latter is mainly attributed to tablet forms of the therapy.

Undesirable effects apart from the above include stomach pain, and possible vaginal bleeding that can be called relatively abnormal or heavy. Indigestion may also trigger effects such as bloating, and this can be quickly managed through symptomatic treatment. Indigestion can be avoided by consuming food with the tablets, and this could help reduce the intensity of indigestion and the possible outcomes. Women are also known to experience swelling; this manifests only in certain parts of the body, and not throughout. Women may also experience cramps in the legs, that is known to resolve naturally, without the need for any treatment.


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