What is hormone replacement therapy (HRT)?

Hormone replacement therapy (HRT) is the systemic use of estrogen, with or without progesterone, (and sometimes testosterone) after menopause, to relieve menopause symptoms like hot flashes and night sweats. It also treats vaginal dryness after menopause, but if that is the only problem a woman has, it is usually treated with vaginal estrogen, which is safer than systemic HRT.

Hormone therapy (HT) is the use of synthetic versions of hormones made naturally in the body either to replace hormones that your body is no longer producing (as in menopausal women) or to counteract the effects of hormones that your body is producing.

Hormone therapy for treating menopausal symptoms involves the use synthetic versions of estrogen and possibly also progesterone and small amounts of testosterone that a woman's body makes naturally up until menopause. During and after menopause the loss of these hormones can cause a woman to experience symptoms including hot flashes, decreased sexual desire, vaginal dryness, mood swings and problems sleeping. Taking synthetic versions of estrogen, progesterone (in women who have not had their uterus surgically removed) and possibly even testosterone can help to minimize or eliminate these symptoms.

Hormone therapy can also be used to counteract the effects of hormones that are still being produced in the body. For example, in women who have been diagnosed with estrogen-receptive breast cancer, taking the medication tamoxifen can block the effects of estrogen on breast tissue, reducing risk of breast cancer recurrence. Similarly some men who are fighting prostate cancer are treated with hormones to block the effects of testosterone.

To combat the problems associated with menopausal symptoms, hormone replacement therapy (HRT) became a popular-albeit controversial-treatment to consider.

Because our hormone levels drop as we age, it was thought that injecting hormones could be a way of staying young. The problem with HRT is that it's linked to very serious side effects. Some HRTs have been linked to increased vein clotting-which can escape to the lungs-cancer, and heart attacks.

Although I can't recommend HRT as a first-line therapy, I haven't given up on it in the future. Those women who are prescribed HRT need to take aspirin before taking estrogen. A small percentage of women are prone to making potentially fatal clots when they take hormones, so aspirin can help prevent clotting.