Hormone replacement therapy (HRT)

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Overview

Hormone replacement therapy (HRT)

Definition:

Hormone Replacement Therapy (HRT) is medication containing one or more female hormones, commonly estrogen plus progestin (synthetic progesterone). Some women receive estrogen-only therapy (usually women who have had their uterus removed).

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HRT is most often used to treat symptoms of menopause such as "hot flashes," vaginal dryness, mood swings, sleep disorders, and decreased sexual desire. This medication may be taken in the form of a pill, a patch, or vaginal cream.

Alternative Names:

HRT; ERT (Estrogen Replacement Therapy)

Information:

Based on early studies, many physicians used to believe that HRT might be beneficial for reducing the risk of heart disease and bone fractures caused by osteoporosis (thinning of the bones) in addition to treating menopausal symptoms. The results of a new study, called the Women's Health Initiative (WHI), has led physicians to revise their recommendations regarding HRT.

The WHI, started in 1993, has enrolled 161,809 women, ages 50-79, in 40 different medical centers. Part of the study was intended to examine the health benefits and the risks of hormone replacement therapy, including the risk of developing breast cancer, heart attacks, strokes, and blood clots.

In July 2002, one component of the WHI, which studied the use of estrogen and progestin in women who had a uterus, was stopped early because the health risks exceeded the health benefits. The main reason for stopping the estrogen-progestin study was because of a 26% increase in breast cancer.

In March 2004, a second component of the WHI, which studied estrogen-only therapy in women who no longer had a uterus (see hysterectomy), was stopped early. This was primarily because of an increase in the risk for strokes.

The information below includes detailed information from the WHI study about each risk. A summary follows at the end.

MENOPAUSE SYMPTOMS

During menopause, the amount of estrogen produced by a woman's ovaries drops. These naturally occurring low estrogen levels may cause symptoms that include hot flashes, sleep problems, mood swings, and vaginal dryness.

Most women experience relief from the hot flashes, sleep difficulties, and vaginal dryness within a few weeks of taking HRT. Short-term use (2-4 years) of HRT to treat the symptoms of menopause still appears to be safe at this time. Usually, hot flashes and night sweats are less severe after a couple of years -- especially if HRT is tapered gradually.