Hormone replacement therapy: the benefits and risks of hormone treatment (HRT)
Weighing up the benefits and risks of hormone treatment hormone treatment (HRT)? Understanding the pros and cons can help you decide if hormone replacement therapy is right for you
Hormone replacement therapy is the first-line treatment recommended by NICE for the treatment of perimenopause and menopause symptoms. It is currently taken by 2.6 million women in England [1].
Most women (80%) experience symptoms [2], although symptoms themselves vary between women and you can experience a range of symptoms, which can change with time. Just as symptoms can vary between women, so too can the dose and type of hormone treatment prescribed. There is no one standard hormone treatment treatment – don’t be surprised if your friends’ prescription varies from your own.
Hormone treatment can contain hormones estradiol (estrogen), progesterone and testosterone. They are prescribed separately, and you may find that your dose and type of each may need tweaking during your perimenopause and menopause, to optimise your body’s response to symptoms.
If you want to find out if hormone treatment is right for you or if you need to make an adjustment to your dose or type, book an appointment to speak to a Newson Clinic healthcare professional below.
What are the benefits of hormone treatment (HRT)?
Hormone treatment can improve the symptoms of perimenopause and menopause. For most women, the benefits of hormone treatment outweigh any risks (these depend on your individual medical history and age).
Hormone treatment is an effective treatment across a range of symptoms – it usually very quickly stops hot flushes and night sweats, for instance. Other symptoms such as hormonal low mood and energy, brain fog, vaginal and urinary symptoms such as vaginal dryness and UTIs, muscle and joint pains, lack of libido, headaches, hair and skin changes, changes to periods, anxiety, irritability and heart palpitations usually resolve or improve.
Some of the symptoms of perimenopause and menopause may take a little time to resolve so it is worth giving hormone treatment enough time to work – you should see improvements within three months.
Hormone treatment also benefits your future health and reduces future risk of diseases. Lower levels of hormones are associated with an increased risk of developing health conditions including osteoporosis (bone weakening), cardiovascular disease, type 2 diabetes, dementia and cognitive decline, auto-immune diseases and some cancers. Hormone treatment replaces the hormones your body is missing, so reduces these risks. For instance, taking hormone treatment can help prevent and repair bone loss, and it can lower your risk of developing heart disease [3]. It can also lower your risk of developing type 2 diabetes and bowel cancer [4].
What are the risks of hormone treatment (HRT)?
The risks of hormone treatment will be individual to you – and will depend on your age, your medical history and your family’s medical history, as well as the type of hormone treatment you are given.
For instance, synthetic estrogen tablets are associated with a small increased risk of clot or stroke. However, bioidentical (body identical) estrogen patches, gel and spray are not associated with this risk.
The risk that has gained the most headlines over the years concerns breast cancer. Combined synthetic hormone treatment (strogen and progestogen) may be associated with a small risk of developing breast cancer [5]. However, this risk has not been shown to be statistically significant [6].
The risk of breast cancer is reduced if micronised progesterone is used [7]. It is worth keeping the risk of breast cancer in perspective – it is greater in women who are overweight, do not exercise, drink moderate amounts of alcohol compared to in those women taking any types of hormone treatment [8].
