Hormone Replacement Therapy (HRT), also known as Menopausal Hormone Therapy, involves the administration of hormones to alleviate symptoms associated with menopause. The hormones used in HRT typically include:
- Estrogens: This is the main hormone used in HRT. Estrogens can help to alleviate common symptoms of menopause like hot flashes and night sweats, as well as prevent osteoporosis. Estrogens used in HRT can be natural or synthetic and come in several forms including oral tablets, transdermal patches or gels, vaginal creams, and injections.
- Progestogens: This group of hormones includes progesterone and similar compounds. They are often given in combination with estrogen to women who still have their uterus. This is because taking estrogen alone can increase the risk of endometrial cancer (cancer of the lining of the uterus), but adding a progestogen can reduce this risk. Progestogens can be administered in similar ways as estrogens.
- Combined estrogen and progestogen: These therapies contain both hormones, often in a single pill or patch. The hormones might be administered continuously (both hormones every day) or cyclically (estrogen every day and progestogen on certain days of the month).
- Tibolone: This is a synthetic hormone that has estrogenic, progestogenic, and androgenic properties. It’s used in some countries for treatment of menopausal symptoms, but isn’t available in all countries, including the United States.
- Estrogen agonist/antagonist (also known as selective estrogen receptor modulators or SERMs): These drugs, such as raloxifene, act like estrogen in some parts of the body. They are often used to prevent osteoporosis and might be used in combination with estrogens for women experiencing menopausal symptoms.
- Bioidentical hormones: These are hormones that have the same chemical structure as those produced by the human body. They can be prescribed in standard doses or in custom-compounded formulations.
The choice of which hormone or hormones to use in HRT, and how to administer them, should be individualized based on a woman’s symptoms, health history, and preferences, and should be made in consultation with a healthcare provider.