Hormone Replacement Therapy (HRT)
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Indications for hormone replacement therapy
Main indications for therapy:
- Menopause symptoms. Replacement therapy is prescribed to eliminate hot flashes, night sweats, irritability, insomnia, dry skin and mucous membranes that occur due to decreased estrogen levels.
- Osteoporosis prevention. After 50 years, bones become more fragile due to a lack of hormones. Treatment helps strengthen bone tissue and reduce the risk of fractures.
- Early menopause or surgical menopause. If menopause occurs before 40 years or the ovaries are surgically removed, medications help prevent premature aging of the cardiovascular system, bones and skin.
- Endocrine disorders. Prescribed for decreased ovarian function (hypogonadism) or after treatment that affects hormonal balance, such as radiation therapy.
- After operations on the reproductive organs. If the ovaries, uterus or other interventions affecting the hormonal background were removed, therapy helps to restore balance.
- Sexual dysfunction. Vaginal dryness, pain during intercourse, decreased libido can be associated with hormonal deficiency. Drugs eliminate these symptoms.
Why is therapy important? Hormonal deficiency affects many systems of the body: cardiovascular, skeletal, nervous. Replacement therapy not only improves well-being, but also helps prevent serious long-term complications. However, therapy can only be prescribed after examination and consultation with a doctor who will assess the benefits and possible risks.
Contraindications
Hormone replacement therapy is an effective treatment method, but it is not suitable for everyone. Before prescribing treatment, the doctor evaluates the patient's condition and possible risks. Some diseases and conditions make the use of HRT impossible.
Why is it important for women to consider contraindications? Incorrect prescription of hormone replacement therapy can lead to serious complications. Before starting treatment, a thorough examination is required, including blood tests, ultrasound and, if necessary, additional studies.
The main contraindications to hormone replacement therapy for women:
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Oncological diseases
Therapy is contraindicated in hormone-dependent tumors, such as breast or endometrial cancer. Hormones can stimulate the growth of malignant cells.
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Thrombosis and thromboembolism
If the patient has a tendency to form blood clots, replacement therapy may increase the risk of thromboembolism (blockage of a blood vessel by a blood clot).
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Serious liver disease
In severe liver dysfunctions, hormone metabolism is disrupted, making therapy unsafe.
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Cardiovascular diseases
Myocardial infarction, stroke or severe hypertension are contraindications, as therapy may increase the load on the cardiovascular system.
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Uterine bleeding of unknown origin
Before starting medications, the doctor must determine the cause of the bleeding and rule out serious diseases.
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Diabetes mellitus with complications
In case of severe vascular changes or other complications of diabetes, the use of therapy can be risky.
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Pregnancy
The therapy is not used during pregnancy, as it may affect the development of the fetus.
Advantages and disadvantages of hormone replacement therapy
Hormone replacement therapy for women has its pros and cons.
| Advantages | Disadvantages |
|---|---|
| Relieves menopausal symptoms such as hot flashes, sweating, insomnia. | May increase the risk of thrombosis and thromboembolism if there is a predisposition. |
| Prevents osteoporosis, strengthens bone tissue. | With long-term use, there may be an increased risk of some types of cancer (for example, breast cancer). |
| Improves skin condition, reduces dry mucous membranes. | Should not be used in case of serious liver diseases, thrombosis and some cardiovascular diseases. |
| Improves quality of life, stabilizes mood. | May cause side effects such as nausea, headaches or breast engorgement. |
| Maintains cardiovascular health when properly selected. | Requires regular medical supervision and dosage adjustments. |
Hormone replacement therapy effectively eliminates symptoms of hormonal deficiency in women and helps prevent many complications.
If you want to start hormone replacement therapy or learn more, contact the K+31 clinic. Our specialists will select a suitable treatment plan. Write, call and sign up. All prices are listed on the website.
Methods of conducting hormone replacement therapy
Oral medications (tablets)
Pills are the most common form of therapy. They are taken daily at a specific time, which ensures a uniform supply of hormones. This method is convenient for most women, but may not be suitable for those with liver or gastrointestinal diseases.
Transdermal agents (patches, gels)
The drugs are applied to the skin, from where the hormones enter the blood. Patches are glued to certain areas of the body, and gels are rubbed into the skin. The transdermal method allows avoiding the burden on the liver, which makes it preferable for patients with diseases of this organ.
Local forms (suppositories, creams, vaginal tablets)
Topical agents are used to treat local symptoms such as vaginal dryness or discomfort. The medications are applied or injected directly into the area of action, with minimal impact on other organs.
Intrauterine systems
Hormonal IUDs are inserted into the uterine cavity and secrete progesterone over a long period of time. This allows for effective protection of the endometrium from overgrowth (hyperplasia), especially with combined therapy with estrogens.
Injectable drugs
Hormonal injections are used less frequently, but provide a long-term and stable supply of hormones. This method is convenient for patients who find it difficult to adhere to regular medication intake.
How to choose a method?
The choice of method depends on the symptoms and general health. For example, transdermal agents are preferable for liver diseases or increased risk of thrombosis, and local forms are suitable for eliminating exclusively local symptoms. Oral drugs are often chosen to eliminate systemic manifestations of hormonal deficiency. The decision is always made by a doctor after a full examination.
General information
Types of hormones used in HRT
The main types of hormones are:
- Estrogens. These hormones compensate for the decrease in their level, which is typical during menopause or after the removal of the ovaries. Estrogens help eliminate hot flashes, night sweats, vaginal dryness and decreased skin tone. They also prevent osteoporosis (bone loss). Examples: estradiol, estriol
- Progesterones. They are prescribed together with estrogens to women whose uterus has not been removed. Progesterone protects the endometrium (uterine lining) from excessive growth, which can lead to cancer. Examples: dydrogesterone, progesterone
- Combination drugs. These products contain both estrogens and progesterones, making them suitable for most women with a preserved uterus. The combination reduces the risk of complications and simultaneously eliminates the symptoms of hormonal deficiency
- Testosterone. Sometimes used in small doses when there is a significant decrease in libido (sexual desire) or muscle mass. However, use is strictly limited and is carried out under the supervision of a doctor
Hormones are available in different forms to choose the most suitable option for each woman.
Answers to popular questions
Doctors from “K+31” answer:
Is there a “safe” duration of HRT?
The duration of hormone replacement therapy depends on the goals of treatment and the patient's health. Treatment is usually carried out for several years, but the decision on duration is made individually. The doctor regularly assesses the health condition in order to promptly adjust the therapy or stop it, if it is safe.
Is it possible to get pregnant while on HRT?
Hormone replacement therapy is not a means of contraception. If menopause has not yet occurred, the possibility of conception remains. If pregnancy is not planned, it is necessary to additionally discuss with the doctor the choice of a reliable method of contraception.
Does HRT affect weight gain?
Hormone replacement therapy itself does not lead to significant weight gain. Possible changes in body weight are associated with the individual reaction of the body, changes in metabolism or fluid retention. With the correct dosage and compliance with the doctor's recommendations, this effect is minimal.
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What is hormone replacement therapy?
Hormone replacement therapy (HRT) is a treatment method that helps the body restore hormone levels if they have dropped for some reason. It is usually prescribed to women during menopause, when the natural production of estrogens and progesterone decreases. These hormones are responsible for many processes in the body, and their deficiency can lead to unpleasant symptoms and even long-term complications.
How does HRT work for women? The drugs contain synthetic or natural analogues of female hormones - estrogens and progesterone. They replenish the deficiency of these substances, maintaining the body's functioning at a normal level.