Menopause Hormone Replacement Therapy

Options, Benefits and Risks of Hormone Therapy


Menopause Hormone Replacement Therapy (HRT) is certainly a controversial subject  since the results of the Women’s Health Initiative has revealed the risks associated with this treatment.

Since this time, researchers are going over the data with a fine tooth comb, giving women a new recommendation – for now (see sidebar).

Here you will find information about:

  • Estrogen
  • Progesterone
  • Testosterone for women
  • Risks associated with hormone replacement therapy
  • Different delivery forms for hormone therapy
  • An overview about menopause hormones

Because this is such a big issue, this article just provides a broad overview. Just follow one of the picture links for much more information. Alternatively, read on and click on the “return to top” link when you’re done.





Today, there is more than one option for HRT or Hormone Therapy, as it is now called. Newer prescriptions use not only pills but patches, pellets, shots and other delivery options.

Bioidenticals, (hormones identical to the structure the body makes) are also available in several treatment forms, and traditional HRT (such as Premarin and Prempro) are given in lower doses and for shorter times than before. This all is good news for women who are looking for safer ways to use hormones.

Menopause Hormone Replacement Therapy consists predominantly ofEstrogen supplements. For women who still have a uterus, progesteroneneeds to be added to prevent endometrial cancer.

Testosterone is not often used because testosterone replacement for women is difficult and tricky at best.

Bioidentical hormone replacement specialists use additional hormones such as DHEA but this has more to do with trying to stop the aging process and less with menopause symptom relief.

No matter which form of therapy you are considering, hormones are very powerful substances and health risk are associated with the benefits. It is up to each woman to weight the rewards and benefits against the potential risks.

Estrogen Supplementation

Prescriptions of anestrogen supplement is clearly the most frequent of the hormone therapies. The benefits of estrogen go way beyond its role in human reproduction. It benefits your blood vessels and heart, keeps your bones strong, your hair full and the wrinkles at bay.

Let’s not forget that it alleviates the dreaded hot flashes and night sweats. Other menopause symptoms benefit from estrogen as well (such as vaginal dryness, urinary tract infections etc.)

Estrogen Supplements come in various forms such as synthetic estrogenlike Premarin, or as bioidenticals. Natural estrogen replacement (also called bioidentical because its chemical structure mirrors the estrogen in your body) is available either from a compounding pharmacy or by standard prescriptions (such as the Vivelle Patch).

As with all hormones, the effects go beyond the treatment of symptoms. If you add more estrogen to already high levels (estrogen dominance) your symptoms could get worse. But on the other hand, if low estrogen symptoms drive you crazy, this therapy will provide quick relief.

Hormone Replacement Therapy using estrogen is not without risk and side effects. Be aware of those risks and your options so you can make the right decision for you circumstances.

Progesterone Replacement

Progesterone regulates the sleep cycle, balances the mood, relaxes muscles and, most important, balances the effect of estrogenProgesterone replacement can be done with Progestin (synthetic Progesterone) or micronized progesterone.

Bioidentical progesterone replacement is available through creams or gels.

Low Progesterone causes symptoms like

  • Menopause Insomnia
  • Moodiness
  • Anxiety and nervousness
  • Weight Gain
  • Decreased Libido

It is possible to have excess progesterone levels. Symptoms of excess progesterone develop slowly and are due mainly to overuse of any kind of progesterone replacement (incl. bioidenticals).  Find out more about progesterone therapy.

Testosterone for Women

Most women are looking for testosterone replacement because of low sex drive after menopause.

Testosterone for women is a very complicated issue. Several attempts have been made to produce a female hormone replacement for testosterone but to date no successful drug has been developed.

No standard dose recommendation or test that would reliably indicate a surplus or a deficiency in testosterone is available for women.

No matter if synthetic or bioidentical hormone is used - all testosterone replacement to date is designed for men (at least in the U.S.). So if you and your doctor are considering it, you have to be guided by you symptoms.

Also the therapy does not work for every woman and side effects can be unpleasant to say the least. Make sure you read the article about testosterone to learn more.

Menopause Hormone Replacement Therapy Risk

HRT used to be the treatment of choice until the results of the Women’s Health Initiative linked the therapy to an increased risk of heart disease, stroke and breast cancer.

The current thinking among doctors regarding Hormone Replacement Therapy risk is that it is safe if used for the treatment of moderate to severe menopause symptoms. However, it should be used for a maximum of several years around the time of menopause in the lowest effective dose.

Women who have certain risk factors such as a history of breast cancer or heart disease should not use menopause hormone replacement therapy according to current guidelines.

The use of HRT as a long term preventive treatment for age related ailments is not recommended. Risk factors increase the longer the wait from the last period to the start of HRT, or if it is continued long-term.

HRT comes in different forms, using different hormones or hormone combinations. All have their specific risks and potential side effects.

Hormone Replacement Medications

Hormone replacement medication delivers estrogen, progesterone and occasionally testosterone. These hormones can be delivered in various ways:

  • Orally (Pills and tablets)
  • Through the skin (patch, crème, gel)
  • Vaginal inserts
  • Sublingual (medication given under the tongue)
  • Pellets inserted under the skin (testosterone and estrogen)
  • Injections

How the medications are taken can be more important than the brand of hormone replacement medication.

There are pro’s and con’s for each method. Not every hormone can be delivered safely into the bloodstream in the same way. And different delivery methods determine which effects the hormones have.

Find much more about the pro’s and con’s in the article about the various medication forms.

Menopause Hormones

The main female reproductive hormones are the 3 Estrogens, Progesterone, and to a lesser degree Testosterone.

In order to understand the different therapeutic options for menopause treatments it is important to understand at least a little about female hormones.

A better understanding about the interaction of the various hormones helps you to understand why it is so difficult to develop a safe menopause hormone replacement therapy.

Check out the (VERY) basic information for you as background for the other information about hormone replacement.

Menopause Hormone Replacement Therapy is once again a good option for women to treat their menopause symptoms. It should be used after other, more natural methods have failed to help alleviate your symptoms.

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