Contraindications · Known, suspected, or history of breast cancer · Known or suspected history of other estrogen-based cancers, i.e., an official website of the United States government. The government means it's official. Federal government websites often end In. government or.
thousand. Before sharing sensitive information, make sure you're on a federal government site. A service of the National Library of Medicine of the National Institutes of Health.Hormone replacement therapy (HRT) supplements women with hormones that are lost during the menopausal transition. To alleviate symptoms associated with menopause, conventional hormone replacement therapy includes an estrogen and progesterone component to mimic the hormones created by the human ovary.
Estrogen therapies are numerous and include those specific to the human ovary, for example, estradiol and estriol. Other estrogenic compounds include conjugated equine estrogen (CEE), the most commonly prescribed estrogen in the United States. They are not identical in their effect on the human body, but they share the same FDA indications. This activity describes the indications for hormone replacement therapy and highlights the role of the interprofessional team in the treatment of patients with postmenopausal symptoms.
Hormone replacement therapy (HRT) involves supplementing women with the hormones they lose during the menopausal transition. For male hormone replacement therapy, see our complementary StatPearls reference article about male hypogonadism. A progestogen is a term used to include not only progesterone produced by the human ovary, but also substances similar to progesterone, also known as progestins. A woman who wishes to undergo hormone therapy and has an intact uterus must have a progestogen with estrogen to protect her uterus from endometrial hyperplasia or neoplasia.
Estrogen alone will cause the lining of the endometrium to grow. Progestins prevent the lining from proliferating abnormally. It is assumed that if a woman has undergone a hysterectomy, she no longer needs a progestin. However, progesterone is different in that it can alleviate symptoms of sleep disorders and mood instability, and there is increasing evidence to support that it protects breast tissues.
Progestin is usually administered orally, although some are available in combination with estrogen in the form of patches. Progesterone is available in oral form and can also be used vaginally for unapproved uses. by the FDA. When studying the potential adverse effects of HRT, the most frequently consulted information in the United States comes from the Women's Health Initiative (WHI).
This was a multifaceted trial that included two randomized, double-blind, placebo-controlled trials of postmenopausal hormone therapy. The first group included EEC at a rate of 0.625 mg per day with 2.5 mg of medroxyprogesterone acetate (MPA) per day. The second group studied patients who had undergone previous hysterectomies and who had been treated only. with EEC of 0.625 mg. When examining the evidence from European studies in which estradiol derivatives are normally used instead of CEE and progesterone or progestins without MPA, the conclusions are very different and uneven.
Transdermal estradiol alone increased the risk of breast cancer by 10%, but estradiol with progesterone reduced the risk of breast cancer by 10%. These risks do not apply to estradiol and progesterone treatments. Basic scientific studies show several mechanisms through which estradiol (not CEE) is cardioprotective. These include the stabilization of atherosclerotic plaques, the reduction of the intima-media thickness of the carotid artery (CIMT) and the reduction of coronary artery calcium scores (CAC).
Numerous subsequent studies, both in Europe and the United States, show that cardiovascular diseases and deaths decrease considerably when hormone therapy begins within the first four years of the menopausal transition. The timing hypothesis refers to the theory that when hormone therapy is started closer to the time of the transition to menopause, cardiovascular benefit is obtained compared to late onset. Studies using oral estradiol are contradictory, showing a similar risk of stroke, but the incidence of fatal strokes has not changed. HRT and the risk of venous thromboembolism (VTE) Transdermal estradiol does not confer the same thromboembolic risk, as demonstrated by numerous European studies.
The ESTHER study conducted in France showed an overall risk of blood clot formation of 0.9, which represents a reduction in risk. Subsequent studies on other doses and routes of administration of transdermal estradiol confirm these findings, with at least no effect on the risk of blood clotting. These contraindications do not apply to transvaginal estrogen treatments, since the serum estrogen concentration This route is extremely low. The North American Menopause Society (NAMS) has recommended that the black box warning that applies to conventional HRT does not apply to transvaginal estrogen treatments.
Estradiol and progesterone hormone levels are not traditionally measured for monitoring purposes. On the contrary, the alleviation of menopausal symptoms and the absence of adverse effects mean an adequate medical response. There is no scientific evidence to link hormone therapy to significant weight gain. HRT, including androgen therapies, such as testosterone, must be monitored with serum testing, but is not considered a conventional HRT.
National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894 FOIA HHS Web Policies Vulnerability disclosure helps accessibility and careers. Hormone replacement therapy (HRT) helps treat menopausal symptoms, such as vaginal dryness and hot flashes. Age, family medical history, personal medical history, and the severity of symptoms can affect your decision to take hormone therapy. Talk to your healthcare provider about the benefits and risks of HRT, the different forms of HRT, and alternative options.
It's important to make the decision to take hormone therapy after talking to your healthcare provider. People who lose estrogen too soon (before age 40) often receive higher doses to replace what their ovaries usually produce for their age. Women, especially those with signs of urogenital atrophy, also tend to feel embarrassed to report these symptoms or to think that local or topical treatment carries the same risk as systemic treatment of menopausal symptoms, known as menopausal hormone therapy (MHT).). Estrogen therapy is a form of hormone replacement therapy that is frequently used to control and treat menopausal symptoms, especially vasomotor symptoms and urogenital atrophy, which is often associated with a significant decline in quality of life.
These hormones are correlated with a variety of adverse effects, including an increased risk of breast cancer, stroke, heart disease, and deep vein thrombosis. Health care providers also call it hormone therapy (HT), especially when you receive treatment after age 50. A study that showed the adverse outcomes of hormone replacement therapy showed that unopposed estrogen correlates with a higher risk of endometrial and breast cancer. If you have menopausal symptoms that affect your quality of life, you may wonder if hormone therapy is an option for you.
Compound hormones aren't well studied and healthcare providers aren't sure about their long-term effects. This is a complex issue because your risk of heart disease depends on many factors, not just whether you take hormones. Hormone replacement therapy (HRT), on the other hand, generally means that hormones are replacing natural hormones that the body no longer produces, especially in people between the ages of 30 and 40. The duration of treatment for these hormones should not exceed a few years and close monitoring is required.
