Hormone Replacement Therapy (HRT)

We don’t even realize when we hit menopause! 

You never know what you’re going to get. Many women claim “the change” is nothing while some go through a drastic one. 

It’s probably because of the ample number of symptoms menopause brings its way? 

Apparently, there are 34 different types of symptoms! Some of the common ones include-

  1. Hot flashes & night sweats - affecting 80% of menopausal women. 
  2. Weight gain & bloating - affecting 6 in 10 menopausal women.
  3. Mood swings - affecting 70% of menopausal women.
  4. Fatigue - affecting 1 in 5 menopausal women.
  5. Brain Fog - affecting 60% of menopausal women.

So, how do we know when it hits us? 

The worst part is that studies have shown how menopause can hit women, starting as early as when they're in their 30s or late 40s- which is known as peri-menopause.

They also state that these symptoms could last after menopause for up to 20 years- through post menopause. 

However, to be certain you’re going through any stage of “menopause” it’s vital to visit your trusted Doctor or Gynaecologists. They will usually put you through a blood test to check your levels of follicle stimulating hormone (FSH) and estrogen. 

If these tests are positive - increased level of FSH and low levels of estrogen- then, they would usually recommend you to go through a Hormonal Replacement Therapy (HRT). 

So, through this article we will be going on a journey to understand HRT in depth; answering questions like: 

  1. What is HRT? 
  2. Types of HRT - Estrogen, Progesterone & Testosterone therapy (explained)
  3. Is HRT right for you? 
  4. Is there an alternative or method to make HRT efficient? 

What is HRT?

HRT is a treatment used to relieve symptoms of menopause. The treatment involves replacing certain hormones that are at a lower level as you approach menopause. 

3 important hormones drastically fluctuate and decline during menopause - Estrogen, Progesterone & Testosterone. These are involved in making menopause a terror in women worldwide; due to their wide range of symptoms & side-effects. 

Therefore, many doctors recommend either- Estrogen Therapy, Progesterone Therapy, Testosterone Therapy, or a combination of these hormones- depending on the symptoms faced by each individual. 

So, let’s get into the depth of each of these therapies to understand their “pros” & “cons”! 

Estrogen Therapy

Estrogen therapies are recommended by doctors after completing the “FSH” or “Hormonal” blood test, along with the list of symptoms you encounter. 

Normally, estrogen levels start to decline during peri menopause and the rate at which it declines, increases as we get older (till post menopause). Therefore, most of the recommended Hormonal Replacement Therapies include a high dosage of ‘Estrogen Therapy’.

Let’s understand the range of symptoms encountered by menopausal women due to low estrogen levels. 

low estrogen symptoms, oestrogen

List of Menopausal symptoms caused by low estrogen levels: 

  1. Irregular periods/missed period
  2. Infertility 
  3. Weak bones 
  4. Painful intercourse 
  5. Hot flashes & night sweats
  6. Depression 
  7. Increase in urinary tract infections  
  8. Increased weight 
  9. Mood swings - depression, anxiety, irritability
  10. Fatigue, low energy, low concentration level

Therefore, by introducing estrogen therapy- we will increase the amount of estrogen to bring back the balance in our body.

The most common proven benefits of estrogen therapy include: 

  1. Reduced hot flashes & night sweats
  2. Reduced Mood Swings
  3. Reduced Vaginal Dryness
  4. Protecting against bone loss that can lead to hip & spine fractures

However, certain risks that come with estrogen therapy: 

  1. Breast cancer
  2. Ovarian cancer
  3. Womb cancer
  4. Blood clots
  5. Heart diseases & strokes
  6. Deep vein thrombosis
  7. Uterine lining growth (which can increase the risk of uterine cancer as well)

Progesterone Therapy

Progesterone therapies are recommended by doctors after completing the “FSH” or “Hormonal” blood test, along with the list of symptoms you encounter. 
Normally, progesterone levels start to decline during menopause, as progesterone is primarily produced during the menstrual cycle (ovulation phase) and during pregnancy to increase fertility.

Therefore, most of the recommended Hormonal Replacement Therapies include a high dosage of ‘Progesterone Therapy’. 

Let’s understand the range of symptoms encountered by menopausal women due to low progesterone levels.

low progesterone level, HRT

List of Menopausal symptoms caused by low progesterone levels: 

  1. Headaches or migraines
  2. Mood changes - including anxiety or depression
  3. Irregularity in the menstrual cycle
  4. Infertility (Miscarriages during pregnancy)
  5. Abnormal uterine bleeding 

Therefore, by introducing progesterone therapy- we will increase the amount of progesterone to bring back the balance in our body.

The most common proven benefits of progesterone therapy include: 

  1. Reduced hot flashes and night sweats
  2. Reduced insomnia/sleep disturbances
  3. Treats osteoporosis
  4. Reduces abnormal thickening of the endometrium 
  5. Reduces breast pain

However, certain risks that come with progesterone therapy: 

  1. Arterial disease 
  2. Breast cancer
  3. Depression 
  4. Liver disease
  5. Vaginal bleeding


Testosterone Therapy

Testosterone therapies are recommended by doctors after completing the “FSH” or “Hormonal” blood test, along with the list of symptoms you encounter. 

Although known as the “male” hormone, testosterone is also important for menopausal women as it- plays a key role in the production of estrogen. Like the other hormones, testosterone also starts to decline during menopause. 

Therefore, most of the recommended Hormonal Replacement Therapies include a small dosage of ‘Testosterone Therapy’. 

Let’s understand the range of symptoms encountered by menopausal women due to low testosterone levels.

low testosterone symptoms

List of Menopausal symptoms caused by low testosterone levels: 

  1. Dry skin
  2. Thinning skin or hair
  3. Painful intercourse
  4. Fatigue & poor tolerance for exercise
  5. Loss of muscle tone
  6. Poor memory or concentration
  7. Loss of libido
  8. Depression or anxiety
  9. Gaining fat around the abdomen or “love handles” 
  10. Difficulty building or maintaining muscles
  11. Loss of bone density or osteoporosis

Therefore, by introducing testosterone therapy- we will increase the amount of testosterone

The most common proven benefits of testosterone therapy include: 

  1. Increased fertility 
  2. Increased sex drive
  3. Increased red blood cell production
  4. Increased muscle mass & fat distribution
  5. Protecting against loss of bone density
  6. Reduces irregular menstrual cycle
  7. Reduces sleep disturbances
  8. Reduces vaginal dryness

However, certain risks that come with testosterone therapy: 

  1. Hair loss
  2. Acne
  3. Excess facial hair
  4. A deepening voice
  5. Enlarged clitoris


Is Hormone Replacement Therapy (HRT) right for you? 

HRT has been used for 50 over years by many menopausal women to cure their symptoms. 

A large randomized placebo-controlled clinical trial recently raised questions about the short-term risk and long-term benefit of HRT. 

This study and clinical trial show that HRT is very effective in the treatment of vasomotor symptoms (hot flashes and night sweats). It has also been proven to reduce vaginal dryness and urethritis. 

Additionally, the trial showed intermediate outcomes of cardiovascular benefit and prevention of bone loss, but clinical trial evidence showing prevention of cardiovascular disease or a hip fracture is lacking. 

However, HRT has been on the news recently on the news for the risks it causes (short-term or long-term). Studies have shown possible risks of breast cancer and blood clots due to HRT. 

Women who have or previously had-  breast cancer, ovarian cancer, uterus cancer, cervical cancer, endometrial cancer, blood clots in the legs or lungs, stroke, liver disease or unexplained vaginal bleeding should usually not take HRT. This is especially true for women who have estrogen-positive breast cancer. 

Although, all in all- despite the health risks, HRT is still the most effective treatment for most menopausal symptoms. Most doctors run thorough tests and understand the details of your ‘medical history’, lifestyle and hormonal imbalance before prescribing the correct type of HRT treatment for you. 
If you are on HRT you might ponder on methods to reduce the possible risks and side-effects of HRT.  

How can you reduce the risk of HRT? 

Talk to your doctor regarding some strategies listed below: 

1. Minimize the amount of medication you take. 

You can start by using the lowest effective dose for the shortest amount of time needed to treat your symptoms. 
However, if you’re younger than 45, you might need enough estrogen to protect against the long-term health effects of hormone deficiency. 

2. Find the best product and delivery method for you.

There are various methods to take HRT - pill, patch, gel, vaginal cream, or slow-releasing suppository or ring you can place in your vagina. 
Therefore, it is important to understand which form of consumption suits your body type the best by keeping an eye out for ‘reactions’. 

3. Seek regular follow-up care.

It is essential to regularly follow-up with your doctor to ensure that the benefits of HRT continue to outweigh the potential risks. 
Additionally, it’s important to go for regular mammogram screenings and pelvic exams. 

  • aged 45 to 54 should go for a mammogram yearly
  • over age 55 should go for a mammogram every 2 years
  • women who are or have been sexually active should have a Pap test every 3 years


Is there an alternative to HRT? 

This might be useful for women who: 

  1. Opt-out from HRT. 
  2. Are recommended not to go through HRT. 
  3. Want to increase the benefits of their HRT. 

Here are some tips and methods for you to try! 

1. Work on your diet

Many things you eat could trigger various menopausal symptoms. For example: 

  • High blood sugar levels could cause drastic mood swings or fatigue
  • Dehydration or consuming spicy food could cause hot flashes and night sweats
  • Eating food with high sodium could retain salt & water in your intestine causing you to feel bloated. 
  • Lack of vitamin D and calcium could increase the risk of osteoporosis and loss of bone density
  • Increasing the amount of soy or plant based phytoestrogens could help reduce most menopausal symptoms.

2. Regular Exercise

Exercise helps to stabilize your blood sugar level, give you more energy and boost your mood. Studies have shown increased or regular exercise helps reduce the risk of osteoporosis, improve your sleep quality and aid in weight management. 

Some common and proven exercise routines are: 

  • Aerobic exercise: running, brisk walking, swimming, cycling, etc, helps to maintain a healthy weight, reduces the risk of heart diseases and releases mood-boosting endorphins. 
  • Resistance training: this helps preserve your bone mass and reduces the risk of osteoporosis. Additionally it adds muscle mass to your body, reduces anxiety, and improves mental health. 
  • Flexibility training: yoga, pilates or regular exercise improves your coordination and improves arthritis and other bone conditions.

 3. Herbal Supplements

There are some herbal supplements which have been traditionally used to help manage various menopause symptoms. 

(I) Dong Quai

This herb has been traditionally used in Chinese medication when it comes to improving women’s health. These have properties to alleviate insomnia and fatigue. Additionally, studies have shown it to reduce hot flashes & night sweats in menopausal women within 12 weeks. 

This magical herb is found in our leading sleep supplement- inergySLEEP- which has helped many women with their anxiety, depression, mood swings, fatigue and insomnia.  

Dong Quai, natural menopause relief 

(II) Blue Ginger

Has been clinically proven to be a fast, effective and safe way to boost energy. Studies done on a study group showed in increase of alertness and focus by 30% for up to 5 hours without crashes or jitters. 

This magical herb is found in our leading sleep supplement- inergyPLUS- which has helped many women with their fatigue, brain fog and mood swings.

 blue ginger, natural menopause relief

(III) Moringa & Curcumin

These herbs have been traditionally used in both Ayurvedic and Chinese Traditional Medicine treatment to reduce inflammation our body- to effectively manage weight,  reduce bloating, and reduce joint pains.

Additionally, they have been clinically proven to work together to regulate mood, boost cognitive function, boost energy, and maintain healthy blood sugar levels.

These effective herbs are found in our leading probiotic supplement- Provitalize- which has helped thousands of women to combat unwanted weight gain, bloating and boost energy. 

moringa and curcumin, natural menopause relief

We hope this detailed article on Hormone Replacement Therapy has helped you understand the pros and cons better.