2. Systemic Hormone Therapy vs. Low-Dose Therapy
Now that we’ve covered the two types of hormone therapy (estrogen-only and estrogen and progestin), it’s also broken down into systemic hormone therapy and low-dose therapy. Systemic can come in the form of the pill, skin patch, gel, cream, or spray. This therapy is most effective for hot flashes and night sweats. “Estrogen can also ease vaginal symptoms of menopause, such as dryness, itching, burning and discomfort with intercourse,” says the Mayo Clinic.
On the other hand, low dose hormone therapies typically come in the form of cream, tablet, or ring and are most effective for treating vaginal and some urinary symptoms. They do so in a much lower dosage that is considered to be safer for certain women. “Low dose hormone therapy, used judiciously, still remains the most effective way to treat the troubling symptoms of menopause for those who need it and who can use it safely,” writes the Huffington Post.
3. It Comes in Many Different Forms
The last break down of hormone replacement therapy that we need to discuss are the many different forms. As we previously mentioned, hormone therapy is accessible through pill, cream, gel, skin patch, spray, rings, and suppositories. Each form of treatment has it’s own advantages and disadvantages, as well as benefits and risks. To learn about this in more detail, check out our article Pros and Cons of Each Type of Hormone Replacement Therapy, but we’ll give a brief overview here.
Estrogen treatment in the form of pills is the most common hormone replacement therapy, according to WebMD. They are often taken once a day with food, but they can come with a more complicated schedule. This form of HRT has been the most widely studied, so there’s a lot of information on it! Estrogen pills are best known for reducing or resolving the symptoms of menopause, primarily hot flashes. They can also lower the risk of osteoporosis. The biggest downside is that they can cause an increased risk of blood clots, strokes, and when combined with progestin can raise the risk of heart attacks (mainly for women who have a history of cardiovascular events). Also, because they are synthesized through the liver, they are not recommended for people with stomach problems or a history of liver damage.
The next form of treatment are skin patches which often come in the form of low-dosage of estrogen and are really usually only prescribed to treat the risk of osteoporosis and not menopause symptoms. The estrogen is absorbed directly into the blood, unlike the pill which is through the liver. Since they are worn on the skin, the biggest downfall is that the patient has to be wary about sun and heat exposure.
Next up, topical creams, gels and sprays are also applied directly to the skin and absorbed directly into the blood. The specifics of how they are applied vary dependong on the product, but for the most part are applied to the arms or legs. The pros for this form are the same as the patch, but the con is that there hasn’t been as much research and because it’s applied topically, there’s a risk it can be rubbed off before it’s absorbed or that it can be transferred to other people, if not careful.
Lastly, suppositories, rings and creams are the most common for treating vaginal specific symptoms like dryness, itchiness, burning, or pain during intercourse. These forms of hormone treatment are applied directly to the vaginal area making them extremely targeted. Similar to the other forms, they are a low dosage so they don’t pose much risk for blood clots, cancer, or cardiovascular events, but as a downfall, they can’t treat hot flashes.