Hormone Replacement

For women suffering from menopausal symptoms

It is based on the idea that the treatment may prevent discomfort caused by diminished circulating estrogen and progesterone hormones, or in the case of the surgically or prematurely menopausal, that it may prolong life and may reduce incidence of dementia. It involves the use of one or more of a group of medications designed to artificially boost hormone levels. The main types of hormones involved are estrogen, progesterone, or progestins, and sometimes, testosterone. It is often referred to as “treatment” rather than therapy.

Hormones are special chemicals that your body makes. The job of hormones is to control how different parts of your body work. The main female hormones are estrogen and progesterone (pro-jes-ter-own) which are made by your ovaries. These hormones are a very important part of your reproductive system.

Estrogen is made during your menstrual cycle. Its job is to grow a thick layer of tissue inside the uterus (womb) each month. Estrogen also affects your bones and the health of your heart and blood vessels. Progesterone is made by your ovaries during the second half of your menstrual cycle. It further thickens the lining of the uterus. During menopause, usually in the late 40s or early 50s, your ovaries slowly stop making these hormones.

What are the reasons I may not have enough estrogen?

Menopause. The most common reason for having low estrogen is menopause. Another name for menopause is “change of life” or “the change.” This is a time in a woman’s life when menstrual or monthly periods slow down and with time, completely stop. Menopause usually begins at age 45 years to 50 years. The average age when a woman’s monthly period stops is 51 years. But a woman can go through menopause much younger.
Removal of ovaries. Estrogen levels will drop if a woman has both ovaries removed. Menopause symptoms start right away when the ovaries are removed because there is no more estrogen.
Other reasons. Too much exercise may cause your estrogen level to drop, which can stop your monthly periods. Your estrogen level may also drop if you lose large amounts of weight.

What are the signs and symptoms of a low estrogen level? You can have physical and emotional changes when your estrogen level is low.

Hot flashes. This is the most common symptom of menopause. A hot flash is a sudden feeling of heat that spreads throughout your body. Your skin may also sweat or blush. Hot flashes usually happen at night and may wake you up. You may have hot flashes on and off for many years.
Osteoporosis (ah-stee-o-per-o-sis). This is also called bone loss. After menopause a woman’s bones begin losing calcium and protein. This may cause brittle bones, which can make older woman more likely to break bones.
Heart and blood vessel disease. Heart disease is the leading cause of death of women in the U.S. Estrogen seems to help prevent heart disease. You are more likely to have heart and blood vessel disease after menopause.
Emotional changes. Low estrogen levels may cause emotional changes. These emotional changes may be linked to physical changes, like losing sleep because of hot flashes. Some women feel nervous, depressed, tired, or short-tempered. You may also have concentration problems (staying focused).
Vaginal dryness. The lining of the vagina may get thinner and less elastic because of dropping estrogen levels. A decrease in estrogen may cause your vagina to become dry. These changes may cause you to have pain during sex.

Will HRT help these symptoms? You may choose to take HRT to help or prevent the symptoms of low estrogen. Hot flashes and night sweats will occur less often and may possibly go away if you take estrogen. Estrogen helps prevent vaginal dryness and thinning of the tissue inside the vagina. Your chances of breaking a bone are much lower if you take estrogen. HRT may also improve your mood and memory. HRT may reduce your risk of heart disease.

Is HRT safe?

HRT is not right for everyone. There is some concern that taking estrogen may cause cancer of the endometrium (end-o-mee-tree-um). The endometrium is the lining of your uterus. You do not need to worry about this if you have had your uterus removed during surgery. Taking progestin with estrogen may decrease the risk of getting this kind of cancer. Progestin is a man-made kind of progesterone. It is not known if progestin blocks any of the benefits that estrogen adds to prevent heart disease.

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