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Risks and Benefits of Hormone Replacement Therapy


Hormone replacement therapy (HRT) has been used to treat menopause symptoms for a long time now because it still to this day is the most effective treatment for menopausal symptoms like hot flashes and discomfort. The Mayo Clinic notes that HRT has also been found to prevent bone loss and reduce fracture. However, since 2002 when the Women’s Health Initiative (WHI) trial discovered that hormone replacement therapy could increase a woman’s risk of breast cancer, heart disease, stroke, and blood clots, the number of women taking medication to treat their menopause dropped dramatically. Since then, the U.S. Food & Drug Administration and Health Canada require all estrogen prescriptions to carry a black-box warning of the risks.

The bottom line is that while there are benefits to hormone replacement therapy, there are also risks. There are many factors that need to be taken into consideration before a woman decides to use HRT to treat her menopause symptoms. Each woman is unique in not only her own symptoms, but also how she will respond to treatment. There are also a variety of factors that come into play when determining who is at risk. Some women are more eligible than others, and for some women, it’s safer. The only way to determine if it’s right for you, is to consult with a doctor.

1. Hormone Therapy Overview

Before we get into the details, we have to explain the two different types of HRT and two most common forms of treatment. The first type of HRT is estrogen-only therapy (ET). This form of treatment provides the best relief of menopausal symptoms, but it is only prescribed to women who do not have a uterus due to a hysterectomy, explains the North American Menopause Society (NAMS). The second type of HRT is EPT which is a combined treatment of estrogen and progestogen therapy. “Progestogen is added to ET to protect women with a uterus against uterine (endometrial) cancer from estrogen alone,” writes the source.

The two ways to take HRT are with systemic products that circulate through the bloodstream, like with a pill, patch, gel, cream or spray, and according  to the Mayo Clinic, this “remains the most effective treatment for the relief of troublesome menopausal hot flashes and night sweats.” The second is local (nonsystemic) products that target a specific area of the body. The North American Menopause Society says this would come in the form of a cream, ring, or tablet and is more often used for vaginal symptoms.

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