It’s common to discuss menopause as a natural part of ageing, as a way of consoling someone who is going through the struggles of hormonal imbalance. It’s true that menopause is natural, but that doesn't mean you have to endure the discomfort that often accompanies it. If hot flashes, night sweats, mood swings, and sleep disturbances are starting to disrupt your daily life, then it’s time to do something about it. Hormone Replacement Therapy (HRT) is one solution that can potentially alleviate symptoms and improve overall well-being.
As with any treatment, there are both benefits and risks to consider before you commit to a plan. We’ve done our best to highlight all the things you need to know about HRT as you evaluate going down that road. Many of these talking points are also things you can (and should) discuss with your GP further.
Menopause and its Challenges
On average, menopause occurs around the age of 51 in Australia, marking the end of menstrual cycles and fertility. Any age between 45 and 60 is common, although some women experience premature or early menopause. During perimenopause, many women will start to experience menopausal symptoms such as:
- Hot flashes and night sweats
- Sleep disturbances
- Mood swings and irritability
- Vaginal dryness and discomfort
- Decreased libido
Any of the above will cause discomfort at the very least. But these symptoms can also impact mental health and overall quality of life quite significantly.
What is Hormone Replacement Therapy?
Hormone Replacement Therapy is a treatment with a relatively simple premise. By replenishing declining hormone levels, primarily oestrogen and progesterone, you effectively stabilise some of the hormone fluctuations. This is an attempt to directly address the cause of menopausal discomfort rather than merely masking symptoms.
Benefits of Hormone Replacement Therapy
Relief from Common Symptoms
HRT has been shown to reduce the frequency and severity of hot flashes, night sweats, and other menopausal symptoms. When successful, treatment can significantly improve sleep quality, mood stability, and overall comfort within weeks of starting.
Improved Bone Density
Because of oestrogen’s vital role in maintaining bone density, declining levels during menopause can lead to accelerated bone loss and increased risk of osteoporosis. HRT helps maintain bone density, reducing the risk of fractures and also potentially enhancing long-term skeletal health.
Cardiovascular Health
Recent studies indicate that HRT, especially when initiated near the onset of menopause, can provide cardiovascular benefits. While further research needs to be done, properly administered HRT has been associated with improved heart health and lowered risk of cardiovascular disease.
Emotional and Cognitive Stability
Hormonal fluctuations during menopause are a known cause of emotional disturbances, anxiety, and cognitive fog. When these fluctuations are managed, it often improves overall mental health and ability to think clearly.
Types of Hormone Replacement Therapy
HRT is available in several forms, but it’s very important that both you and your GP know which type of HRT is suitable for you:
- Oestrogen-only therapy:Recommended primarily for women who have undergone a hysterectomy, as there’s no risk of endometrial hyperplasia in the absence of a uterus.
- Combination therapy (estrogen and progesterone):Suitable for women with an intact uterus, as progesterone protects against the risk of endometrial cancer.
Treatment itself can be delivered via various methods, including pills, patches, gels. There is flexibility based on personal preference and medical guidance, but your GP may also suggest a method based on safety concerns. We’ll address this below.
Should You Be Concerned About Safety?
Safety is an essential consideration with any medical treatment, and HRT is no different. However, you may have misconceptions about hormone treatment that are no longer relevant for modern treatment. While early research raised concerns about cancer and blood clot risks, more recent studies suggest these risks are significantly lower than previously thought, particularly when treatment is started within ten years of menopause onset.
- Cancer risks: Oestrogen without progesterone does increase the likelihood of endometrial cancer if your uterus is still intact, but this risk is mitigated by correct treatment. Modern progesterone does not pose any serious concern, and any women with a hysterectomy will not be at risk from oestrogen-only HRT. Elevated risk of breast cancer due to long-term HRT remains minimal compared to factors such as obesity or alcohol consumption and has not been shown to remain after treatment concludes.
- Blood clots: An older study linked HRT to an increased chance of blood clots when taken orally. Recent evidence suggests that the risks associated with oral HRT are very low. Plus, there has been no evidence that taking HRT through forms such as a patch or gel increases your risk of a blood clot.
Nonetheless, it’s essential to discuss personal and family medical histories with your GP. This will help determine the safest and most effective HRT strategy.
Should I Consider Compounding?
Generally, your GP will only prescribe compounding when conventional HRT isn’t getting desired results. However, compounding can be a good alternative option if commercial products are not suitable.
Live the Life you Deserve!
Quality of life matters, even when you have menopause. Hormone Replacement Therapy can provide meaningful symptom relief that can improve your overall physical and emotional health. If menopausal symptoms are disrupting your ability to enjoy the life you deserve, it's worth consulting a GP to explore HRT options.
Written By
Zen Xiao
