Hormone Replacement Therapy - What do I need to know?
Hormone Replacement Therapy (HRT), also called Menopause Hormone Therapy (MHT), Bioidentical Hormone Replacement Therapy (BHRT), or simply hormone therapy, is one of the most effective treatments for managing the symptoms of perimenopause and menopause. While these terms are often used interchangeably, it’s important to distinguish between synthetic hormone formulations and bioidentical hormone therapies.
Types and Delivery Methods of Hormone Therapy Hormone therapy is available in various formulations, including:
Oral: Pills taken by mouth.
Topical: Patches, creams, gels, or sprays applied to the skin.
Vaginal: Rings or suppositories for localized treatment.
Pellets: Small implantable devices placed under the skin for continuous release.
Understanding Bioidentical Hormones
Bioidentical hormones are derived from plant sources and are chemically identical to the hormones produced by the human body. These hormones are available in two primary forms:
FDA-approved formulations: Manufactured by pharmaceutical companies in standardized dosages.
Compounded formulations: Customized by accredited compounding pharmacies based on an individual’s unique needs. These pharmacies are regulated by state pharmacy boards, adhere to United States Pharmacopeial (USP) guidelines, and are subject to FDA inspection.
Understanding Synthetic Hormones
Synthetic hormones are created from man-made chemical compounds. While they differ chemically from bioidentical hormones, they are not inherently inferior. However, synthetic hormones may interact differently with hormone receptors in the body, sometimes leading to increased side effects. These formulations are typically found in FDA-approved medications available at commercial pharmacies.
Clinically Proven Benefits of Hormone Therapy
Hormone therapy has been shown to offer the following benefits:
Reduced Risk of:
Heart disease
Osteoporosis and fractures
Type 2 diabetes
Dementia
Colorectal cancer
All-cause mortality (death from any disease)
Improvements Seen In:
Frequency and severity of menopausal symptoms
Metabolic health
Genitourinary health (e.g., vaginal dryness, urinary discomfort)
Skin elasticity and moisture
Mental health, including mood stability
Overall quality of life
Making an Informed Decision
Starting hormone therapy is a significant decision that requires careful consideration of the benefits and risks. Your choice should be informed by accurate, up-to-date medical information and tailored to your personal preferences and health profile. A thorough consultation with your healthcare provider is essential.
If your provider is skeptical or dismissive of hormone therapy, consider seeking a second opinion. Hormone therapy is a medically validated treatment aimed at alleviating symptoms, improving health outcomes, and enhancing quality of life. It is not a matter of belief but a well-supported medical option for women navigating the menopausal transition.
Medical Disclaimer
Yes, I’m a women’s health physician, but I am not currently evaluating you in person, do not have your full medical history, and am unable to comprehensively provide adequate medical decision-making on an individual basis. As such, the information I have shared in this document is for educational purposes only and does not replace medical advice from your personal health care provider.
