HRT and its Implications
For menopausal women, HRT presents a wide array of benefits but one has to bear in mind that long term use can have a serious side effects also.
These side effects have been in news a lot lately leading to a reappraisal by the medical community on how to administer HRT and who should be its beneficiaries. In UK, the recommendation now is to prescribe HRT to women who experience severe menopausal side effects. For those, who are not suffering menopausal side effects, HRT’s risks outweigh any possible benefits.
Doctors in the UK have said that in the short term, the risks of HRT are minimal. But the longer a woman continues hormone replacement therapy (HRT), the greater is the risk of developing complications like breast cancer and strokes.
HRT comes in different forms. There is estrogen-only HRT, which tends to be given only to women who don’t have their uterus as it can increase the risk of developing endometrial cancer. This is because increased level of estrogen causes the endometrial lining of the uterus to build up. The other types of HRT also contain estrogen, as the goal of hormone replacement therapy is to replace the estrogen that the body is producing less of. But they have a type of progesterone called progestogen added to them. Progestogen is an oral form of progesterone that counteracts the build up of uterine tissue. It is stronger than progesterone cream, which does not counteract the effects of estrogen on the uterus.
Hormone replacement therapy can be taken orally, as a patch, a cream, gels, nasal sprays, implants, a pessary, or as a vaginal ring that contains estrogen.
It’s important to remember that HRT is not a contraceptive. So, if you are still menstruating when you start taking hormone replacement therapy, you’ll still need to use some form of birth control. The form of HRT given to women who are still menstruating is a sequential combined HRT. Estrogen is taken every day, but progestogen is taken for 12 to 14 days of a woman’s cycle. Thus, women will still bleed every month. It should only be light however. As HRT doesn’t cause ovulation or restore fertility, these will not be like regular periods. However, if your body is still ovulating naturally, however irregularly, there is a risk of falling pregnant even whilst taking hormone replacement therapy. Whilst the chance of falling pregnant is lower, as many as two thirds of the women between the ages of 40 and 44 are still ovulating regularly. So, it’s important to consider some form of contraception if you don’t want to fall pregnant.
