top of page

Hormone Replacement Therapy: The Basics

Hormone Replacement Theory (HRT or HT) is a treatment plan which involves using medications which contain hormones, such as estrogen and progesterone. As women age and experience perimenopause and menopause, they start producing less of these hormones naturally. These medications are used to replace or supplement the hormones that the body would naturally produce. Estrogen therapy has been found to be an effective treatment for relieving the discomfort caused by hot flashes and for the prevention of bone loss.

Progesterone, or progestins, are often prescribed to help regulate menstrual cycles as well as to prevent the thickening of the uterine lining which can lead to pre-cancer or cancer of the uterus (otherwise known as endometrial hyperplasia). Both are often prescribed in tandem for women experiencing menopause who have uteruses. For women who have had hysterectomies, often only estrogen replacement therapy is prescribed.

Estrogen is available in pill form, creams, vaginal rings or tablets, patches and even sprays. Combination Estrogen/Progestin treatment is often prescribed in either pill or patch form. Ask your doctor which treatment plan is right for you.

Benefits of HRT

Going through perimenopause and menopause can be uncomfortable. HRT can help alleviate that discomfort by providing relief from the common symptoms of menopause and perimenopause such as hot flashes, night sweats, sleep disturbances, mood swings, vaginal dryness and osteoporosis. Studies have also shown that HRT can help prevent tooth loss and may lower the risk of both colon cancer and diabetes.

Risks and Considerations

HRT has a lot of benefits for women experiencing perimenopause and menopause but there are also risks. Studies have shown that women who are prescribed HRT have an increased risk of blood clots and strokes, as well as an increased chance of gallbladder/gallstone problems. Starting HRT too late (post midlife) can also increase the risk of dementia. The effects of HRT on women are still being studied and studies testing the impact of HRT on heart disease have been mixed. Combination HRT has also been found to raise the chances of developing breast cancer, showing an increased risk of one extra case of breast cancer per 1000 people each year. HRT is not recommended for anyone who has had breast cancer or endometrial cancer, abnormal abdominal vaginal bleeding, has an increased risk for blood clots, a history of stroke, heart attack or increased risk for vascular disease, are pregnant or have liver disease.

Side Effects of HRT

Almost all medications have side effects and HRT is no different. The most common side effects associated with HRT are: monthly bleeding, irregular spotting, breast tenderness and mood swings. Some people may experience things like fluid retention, headaches, skin discoloration, increased breast density and skin irritation due to the estrogen patch. Most people will experience mild side effects when taking HRT.

Alternative Approaches

For people who cannot or prefer to not use HRT, there are alternative approaches that can help manage the symptoms associated with perimenopause and menopause. Increased exercise, improved diet and stress-reduction techniques have proven to help alleviate some of the symptoms women experience. There are also non-hormonal medications like selective serotonin reuptake inhibitors which have shown to be effective in managing hot flashes and mood swings. For those seeking a more natural route, herbal remedies like black cohosh and evening primrose can help provide relief for some women.


bottom of page