Hormone replacement therapy

A Hormone replacement therapy (HRT) can be used during a woman's menopause and far beyond. This is the period during which the ovaries gradually stop producing hormones and the body's own production of the hormones estrogen and progestin comes to a standstill. Hormone replacement therapy is used, among other things, to relieve menopausal symptoms such as hot flashes, loss of libido, sleep disorders and vaginal dryness.

What is hormone replacement therapy?

At a Hormone replacement therapy The aim is to compensate for the lack of estrogen and progestin in a woman's menopause, which takes place between the ages of 45 and 55, and in the subsequent period (postmenopause).

With the stagnating hormone production during the menopause, stressful biological changes often occur in women, which can be slowed down by hormone replacement therapy. Hormone replacement therapy is administered either in the form of tablets, hormone patches or vaginal suppositories or vaginal creams and usually consists of a combination of estrogens and progestins.

Hormone replacement therapy is not intended to restore the previous hormone concentration in the body, but rather to alleviate the symptoms caused by hormone deficiency.

Function, effect & goals

Until ten years ago that was true Hormone replacement therapy as the ideal solution to reduce the symptoms of menopause. In the meantime, however, it has been proven that this therapy can also be associated with considerable dangers. Many women still go for hormone replacement therapy, either because they have severe menopausal symptoms or because they have been convinced that hormone replacement therapy can protect them from osteoporosis (decrease in bone density), heart attacks, or depression.

In fact, hormone replacement therapy reduces the number of symptoms such as sweating, loss of libido, and mood swings. The decrease in bone density has also been shown to slow down in the course of this therapy.

With hormone replacement therapy during and after menopause, the cosmetic goal of preventing wrinkles and thus maintaining a rejuvenated appearance can also be pursued. The therapy is also used to reduce urinary tract infections.

Before hormone replacement therapy is prescribed, a detailed gynecological examination is carried out by the gynecologist and, in many cases, a blood test is used to determine the hormone level. The doctor then discusses the benefits and risks of hormone replacement therapy with the patient. Due to possible risks, it must be determined individually what the lowest effective dose is for the respective patient and for how long she should carry out the therapy.

It is recommended that women over 60 no longer use hormone replacement therapy. An average of three to five years of treatment is assumed, after which the hormones are gradually reduced and then stopped entirely.

Hormone replacement therapy can be administered through various preparations. The doses that were administered earlier in the early years are now considered too high. In the meantime, the dosage is as low as possible in order to reduce dangers and side effects.

Hormone replacement therapy is often given in tablet form. A dryness of the vagina caused by a hormone deficiency is usually not treated with tablets, but with an estrogen-containing cream, which is much less stressful for the body than tablets. There are now low-dose hormone patches that may also have fewer side effects.

Risks, side effects & dangers

Latest studies show that the risks of a Hormone replacement therapy are possibly greater than their usefulness. It appears that patients treated with hormone replacement therapy are more at risk of developing breast cancer, ovarian cancer, or suffering from a heart attack than those women who are not receiving hormone replacement therapy.

It has also been shown that an increased risk with some pre-existing conditions such as Obesity, arteriosclerosis and high blood pressure exist. Furthermore, there is an increased risk of having a heart attack, thrombosis or gallbladder problems as a result of hormone replacement therapy. Under no circumstances should hormone replacement therapy be used if there is a hormone-dependent tumor such as in breast cancer or uterine cancer. Treatment of osteoporosis with hormone replacement therapy should only be carried out if there is already a high risk of bone breakage and other medications are not an option.

From all of the above, it can be concluded that the benefits and risks must be carefully considered before beginning hormone replacement therapy. Under certain circumstances, well-considered, temporary hormone replacement therapy can be used for severe menopausal symptoms.