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Hormone Replacement Therapy

At Columbus OB/GYN, we understand that the changes your body goes through during menopause can bring about various challenges and unwanted side effects. We are here to support you during this transition and provide you with options to alleviate your symptoms and improve your quality of life. Hormone therapy (HT) is one such option that can help restore estrogen levels and reduce the discomfort associated with menopause.

Understanding Hormones and Menopause

During certain important stages of your life, such as puberty, pregnancy, and menopause, your body undergoes hormonal changes. These changes are natural and play a vital role in various bodily functions. Estrogen, a key hormone produced by the ovaries, influences your reproductive system, menstrual cycle, and bone density.

The Menstrual Cycle
and Estrogen

Throughout your menstrual cycle, estrogen levels fluctuate, guiding the development of the endometrial lining and preparing your body for pregnancy. Around day 14 of your cycle, estrogen signals the ovaries to release a mature egg. If fertilization does not occur, estrogen levels drop by day 28, triggering the shedding of the endometrial lining and resulting in your monthly period.

Menopause and Estrogen Depletion

As you age, the production of estrogen decreases significantly. Eventually, the amount of estrogen becomes insufficient for the thickening of the endometrial lining, leading to the cessation of menstrual cycles. On average, menopause occurs around the age of 50, but it can happen anywhere between 40 and 55 years old. The decline in estrogen levels during menopause can cause a range of side effects, which vary in severity and manifestation for each woman.

Addressing Menopausal Symptoms with Hormone Therapy

Hormone therapy can effectively alleviate the undesirable side effects of menopause and reduce the risk of developing osteoporosis. Here are some common symptoms that can be significantly improved with hormone therapy:

Hot Flashes

Hot flashes are very sudden feelings of heat that can spread over the entire body, causing discomfort, flushing, and sweating for anywhere from several seconds to several minutes. Around 75% of all menopausal women experience hot flashes. They can occur at any time of the day or night and can oftentimes disrupt your sleep. Sometimes, they may occur several times a day or just a few times a month. Hormone therapy can greatly relieve hot flashes.

Vaginal Dryness

Menopause can cause vaginal dryness, making the lining become very dry and thin. This can oftentimes cause pain during intercourse, and the body may be more prone to vaginal infection. Sometimes a woman may experience itching and burning. Menopausal women also may need to urinate more frequently and may be prone more prone to bladder infections. Hormone therapy can help reduce these problems.

Protection from Osteoporosis

Low estrogen levels can contribute to osteoporosis, a condition that results in bone loss. Over time, the bones become more and more fragile and brittle, increasing the risk that they will break- most commonly the wrist, spine, and hip.

Although all women can get osteoporosis, it most commonly runs in families and women with low body weight. Other risk factors include lack of weight-bearing exercise, poor calcium and vitamin D intake, smoking, and use of certain steroids. The use of hormone therapy can help to slow bone loss.

Mood/ Insomnia

Hormone therapy has also been shown to improve the moods of menopausal women and improve sleep problems.

What Are the Risks of Hormone Therapy?

The greatest risk of hormone therapy is an increased risk of blood clots, stroke, and heart attack. Your practitioner will assess your risk factors, such as your health, history, family history, obesity, and smoking, and can determine if you are a good candidate for therapy.

The hormone estrogen causes the endometrium to grow very thick (endometrial hyperplasia), which could lead to endometrial cancer. In order to prevent this, your practitioner will prescribe small doses of progestin to help keep the growth of the endometrium in check. Initially, hormone therapy may cause some bleeding for a short period of time which may last 3 or 4 months.

Although all women are at risk of developing breast cancer, some women who take estrogen and progestin hormone therapy may have an increased risk of developing this disease.

What Does Hormone Therapy Look Like?

There are many types of treatments, including pills, patches, rings, gels, and creams. There is something to fit everyone’s lifestyle and needs. It is important to consider your medical history, age, symptoms, and whether or not you have a uterus. Additionally, hormone therapy can be administered in several ways:

  • Continuous Cyclic Therapy: Estrogen is administered every day in monthly cycles, and progestin is added only during the first two weeks.
  • Continuous-Combined Therapy: Both estrogen and progestin are taken every day.
  • Cyclic Therapy: Estrogen is taken continuously, and progestin is added at varying times along with the estrogen. Times without progestin may cause bleeding.

Once hormone therapy is started, a 3-4 month follow-up visit is suggested to ensure therapy goals have been reached and that side effects are minimal. You may also need an ultrasound and/or endometrial biopsy to check your endometrial growth. In addition, blood tests, pelvic exams, and breast exams may be necessary. Take caution: if you have abnormal bleeding, tell your healthcare provider as soon as possible.


Hormone Therapy from Columbus OB/GYN

Hormone therapy is a safe, effective way to reduce the symptoms of menopause and to prevent osteoporosis. If you are experiencing any symptoms described, talk to your healthcare provider about hormone therapy and whether or not it would be a good option.