We all are creations of God. God has blessed each one of us with unique qualities & features. Out of all the creations of God, Women is considered to be the most beautiful creation for the very fact that only a women have the quality to give birth to another being. Blessed with such a unique quality, fortunate are those who have the ability to give birth naturally. The process of giving birth to an offspring is influenced by many factors such as the health of the women, hormones, etc. There comes a stage in every woman’s life after which she loses the ability to bear children.
After an average age of 45 to 50, a woman’s menstruation cycle stops and she also loses the ability to bear children. During the menopause period, the body produces less of female hormones such as estrogen & progesterone. This reduction in the hormone levels will gradually cause the menstrual cycle to stop thereby lowering the chances of getting pregnant.
The sudden hormonal changes can result in various other symptoms that affect the health of the individual. It might cause troublesome symptoms such as the sudden sensation of warmth which may be associated with flushing or abnormal sweating, mood swings, vaginal dryness and sleep disturbances.
After the first 5 years of menopause, one might encounter progressive bone loss due to decreased levels of estrogen & progesterone hormones. Bone loss is very common among men & women as they age. This could be balanced by intake of vitamin D supplements. But, the post-menopause period puts an extra strain on bones in addition to usual age-related bone problems.
What do you mean by estrogen & hormone therapy?
An estrogen therapy alone may cause uterine cancer therefore to eliminate the increased risk of cancer a progestin is administered along with estrogen. Thus, estrogen or progestin therapy also known as EPT is a combination of estrogen & progestin therapy which is given to a woman having a uterus. The method of prescribing these hormones is also called as combination hormone therapy.
A hormone therapy is a more basic term which refers to the administration of estrogen alone or the combination of estrogen & progestin therapy. The hormone therapy uses a number of hormones to treat the symptoms of menopause. Most of the times, estrogen or progestin are used. Very rarely, testosterone is also added to treat menopause-related symptoms.
The symptoms of menopause include:
- Mood swings
- Less interest in sex
- Sleep disturbances
- Dryness in the female genital areas
- Abnormal body sweats at night
- Anxiety & emotional imbalance
While hormone therapy is used to treat a number of menopause symptoms it also has some risks associated with it. Those include:
- Blood clots in the arteries
- Chances of breast cancer
- Risks of heart diseases &
The hormone therapy comes in different forms. One will have to try different forms to find out the one that suits the best for you! The various forms of hormone therapy are as follows:
The Estrogen comes in the following forms:
- ¨ Skin gel
- ¨ Vaginal rings
- ¨ Vaginal creams or tablets that help overcome dryness or pain during the intercourse
- ¨ Tablets or pills are taken by mouth
- ¨ Skin patches applied to belly & thighs
Those women who have a uterus will have to take progestin pills along with estrogen to lower the risk of endometrial cancer. Women who have had their uterus removed no longer had to worry about uterine cancer and for this reason, only estrogen hormones will do for them.
The various forms of progestin or progesterone are as follows:
- Vaginal creams or tablets
- Skin patches
- Vaginal suppositories &
The type of hormone therapy that doctor implements on you will depend on the kind of symptoms you are suffering from. For instance, skin patches or pills can treat abnormal sweating at nights, on the other hand, vaginal creams, rings or tablets will help overcome vaginal dryness.
How do you take these hormones?
Unlike other tablets, you can’t consume these hormone pills in a manner that you wish to. Your healthcare professional will guide you with this. While taking both estrogen & progestin you will have to follow one of the following schedules.
- Cyclic hormone therapy: this is recommended at the initial stages of menopause. One may use the estrogen in the form of pills or skin patches for about 25 days. The progestin pills could be added between 10 to 14 days. You use a combination of both estrogen & progestin for a span of 2 days and then for about 3 days, you should not take hormones at all. Those who undergo cyclic hormone therapy might encounter monthly bleeding.
- Combined hormone therapy: this kind is preferred when you are asked to consume both estrogen & progestin together every day. Those who undergo combined hormone therapy will also encounter unusual bleeding during the initial stages of menopause. Some may have unusual bleeding when they switch to hormone therapy. Adopting this method will enable them to stop bleeding within a year or so.
If you are at high risk of osteoporosis or if you have severe symptoms of menopause then the doctor might prescribe you other medicines too! For example, the doctor might prescribe you a male hormone, testosterone, to improve your sex drive.
Possible side effects or risk factors associated with hormone therapy:
Most women undergoing hormone therapy would experience side effects in a due course of time. The side effects may be minor or major side effects. Some of the common side effects include nausea, headaches, breast pain, irregular bleeding, & mood swings. It is difficult to differentiate which symptom is due to estrogen component & which is due to progestin.
Some of the more serious health concerns for women undergoing hormone therapy are discussed below:
- HT might increase the risk of deep vein thrombosis (vein clots) & pulmonary embolus (blood clots in lungs). Healthy women need not worry about these conditions.
- Uterine cancer: women who have a uterus and use estrogen alone are at increased risk of uterine cancer. These days, doctors prefer a combination of estrogen & progestin to reduce the risk of endometrial cancer.
- Breast cancer: Recent studies showed that hormone therapy could also increase the risk of breast cancer however, the risk is very small. The risk of breast cancer increases with the duration of use and causes more risk with 5 or more years of use.
- Heart diseases: Hormone therapy lowers the bad cholesterol & increases the good cholesterol in women. However, it increases the risk of heart diseases in women. Especially in women, who have previous heart diseases have more risk of heart attacks.
- Abnormal vaginal bleeding: during the postmenopausal period, women might encounter abnormal vaginal bleeding. What is called as “abnormal” depends on the type of hormone therapy? With continuous therapy, the bleeding might last for 6 months to a year. If the bleeding lasts more than a year then it is called as abnormal bleeding.
- Hormone therapy also slightly increases the risk of stroke, according to a study.
Due to these risk factors such as breast cancer, uterine cancer, stroke & heart diseases most women who do not have major menopause symptoms would wish to avoid hormone therapy.
How is hormone therapy prescribed?
Doctors usually prescribe combinational hormone therapy. Long-term use of estrogen alone increases the risk of uterine cancer. The addition of progesterone counteracts the risk. Estrogen is available in the forms of pills, vaginal rings, vaginal tablets, or vaginal creams. Estrogen pills are also good for vaginal dryness which could be used along with tablets or creams.
Oral therapy: some women prefer to choose daily continuous therapy which involves small doses of estrogen & progestin together. They consume the small doses of hormones each day. For the first time users, it might cause unexpected or irregular bleeding.
Transdermal therapy (patches & spray mists): hormone therapy also uses skin patches for treatment. These patches need to be worn on daily basis and need to be changed once in 2 weeks. These patches are as effective as oral therapy for controlling hot flashes. Spray mists are available as transdermal sprays which can be used once in a day.
Who should & should not take hormone therapy?
- Women with high blood pressure and controlled by medication can undergo HT as it does not elevate blood pressure.
- Those who have a family history of breast cancer or uterine cancer will have a greater risk if not undergone HT.
- HT may be used in women with migraines or liver disease. But, certain types of HT cannot be used in women as it might aggravate these conditions.
- Women who have been already treated for coronary artery disease should not undergo HT.
Some facts about HT
- HT refers to either estrogen or a combination of estrogen & progestin.
- The term Hormone therapy or HT is used to replace the outdated term Hormone replacement therapy or HRT
- The use of estrogen without progestin increases the risk of uterine cancer.
- There are other safe & effective non-hormonal methods for treating women’s concerns regarding osteoporosis.
Medical checkups available for women on HT:
All women undergoing HT should have a medical checkup every year. The doctor will perform a mammogram test to get the x-ray images of the breast. This is used to check for the masses in the breast which might be cancerous cells. The women should also discuss the bleeding pattern with her physician to be sure if that is the expected pattern for her type of HT.
If a woman wants to do against the HT then there are many other ways to deal with the symptoms of menopause. Personal lubrication products such as water-soluble jelly may be applied to the vagina to avoid dryness.