Hot Flashes to Harmony: The Science and Safety of HRT Explained
Introduction
Perimenopause, the transitional phase typically beginning in the mid- to late 40s (or earlier for some), involves a decline in estrogen and progesterone. This decline can sometimes lead to irregular periods and, ultimately, menopause, defined as no period for one year. During this time, many women experience symptoms such as hot flashes, sleep disturbances, joint and muscle discomfort, pain during sex, mood swings, forgetfulness, and difficulty concentrating.
While this transition can be challenging, symptom management is possible. Many women are turning to hormone replacement therapy (HRT) for relief. Fortunately, for menopausal women in Tysons, McLean, Fairfax, Arlington, Vienna, and along the 495 Capital Beltway in Northern Virginia, Dr. Shannon Cothran has founded a medical clinic dedicated to helping women thrive during menopause and is an expert in HRT.
What is Hormone Replacement Therapy?
Hormone replacement therapy (HRT), also referred to as menopausal hormone therapy (MHT), is a treatment designed to supplement and offer a steady state of hormones during the body's declining levels of estrogen and progesterone during menopause. Estrogen is crucial for maintaining functions such as bone density, cardiovascular health, and reproductive processes, while progesterone protects the uterus in women who still have one, reducing the risk of endometrial cancer.
HRT is tailored to each individual’s needs and health history. For women who have had a hysterectomy, estrogen-only therapy may be used, while those with a uterus often require combined estrogen-progesterone therapy. HRT aims to restore hormone balance, alleviate menopausal symptoms, improve bone and cardiovascular health, maintain healthy vaginal tissue and urinary tract, and improve overall quality of life.
Does Hormone Replacement Therapy Help with Menopause Symptoms?
Yes, HRT has been shown to significantly alleviate many menopausal symptoms. It is particularly effective for treating hot flashes, night sweats, mood swings, brain fog, and vaginal dryness. “As a holistic clinic, we have many ways to help women cope with the hormonal and lifestyle changes that come with menopause. HRT is one of the options I discuss with my clients during their early consultation and evaluation,” said Dr. Cothran.
Beyond symptom relief, emerging research suggests HRT may have additional benefits, such as supporting cognitive function and cardiovascular health when started early in menopause. By replenishing estrogen and progesterone levels, HRT can also improve sleep quality and protect against bone loss, which reduces the risk of osteoporosis and fractures. Current recommendations emphasize starting HRT early in menopause and using the lowest effective dose for symptom management.
What Are the Basic Types of Hormone Therapy?
HRT comes in three main forms:
Sequential Combined Therapy: Estrogen is taken daily, and progestogen is added for 12-14 days each month, mimicking the natural ovulation cycle but does not always cause bleeding.
Continuous Combined Therapy: Estrogen and progestogen are taken daily. This method can control menstruation, but oral contraception is a more effective dose to stop or reduce menstruation. This is often recommended for women at least one year past their last menstrual period.
Estrogen-Only Therapy: Suitable for women who have had a hysterectomy. This form excludes progestogen and can also be used locally as a vaginal treatment.
How Do You Administer Hormone Replacement Therapy?
HRT delivery methods fall into two categories:
Systemic Therapy: This method delivers hormones into the bloodstream to reach multiple organs and tissues. Examples include oral pills, nasal sprays, skin patches, creams, and gels. Systemic therapy is effective for symptoms such as hot flashes and night sweats.
Local Therapy: This involves applying hormones directly to a specific area, mostly the vagina. Forms include vaginal creams, rings, or tablets, often prescribed for symptoms like vaginal dryness and painful penetrative intercourse.
Is hormone replacement therapy safe?
For most healthy women within a few years of menopause, HRT is generally safe, with its benefits often outweighing the risks. However, it is not suitable for everyone. Smoking tobacco is a contraindication (meaning a medical condition that makes it unsafe to administer a specific treatment) to estrogen. Conditions such as blood clots, certain cancers, cardiovascular disease, or a history of stroke or heart attack may preclude its use. According to BreastCancer.org, a 2021 analysis revealed that women with a history of breast cancer who used systemic HRT faced a 46% higher risk of recurrence, leading to the recommendation that these women avoid systemic HRT, but vaginal estrogens may still be used in breast cancer survivors.
Consulting a healthcare provider is essential for evaluating whether HRT is appropriate for you. “I have access to medical and family history records when I am prescribing therapy, as well as 15 years of practice as a board-certified OB-GYN, so your treatment plan is evidence-based and truly tailored to your body. That is the benefit of consulting a medical doctor over a medspa or aesthetic service,” said Dr. Cothran.
Who can I speak with about hormone replacement therapy?
When considering HRT, seek a board-certified physician experienced in menopause care. Dr. Cothran, an OB-GYN and Menopause Society Certified Practitioner (MSCP), specializes in creating individualized treatment plans, including hormone therapeutics. At Meno-Start, in the Tysons area of Northern Virginia, her clinic is dedicated to helping women navigate menopause with evidence-based care. Learn more about her medical qualifications in the Meno-Start blog, “The Ultimate Credentials for Menopause Care: What to Look For.”
Conclusion
Navigating menopause can feel overwhelming, but HRT offers a well-researched, effective option for relieving symptoms and improving quality of life. Consulting with an experienced medical professional like Dr. Cothran ensures a personalized approach that prioritizes your health and well-being. By understanding your options and taking proactive steps, you can manage menopause symptoms with confidence and thrive during this stage of life.
Schedule your free tour and meet Dr. Cothran.
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ABOUT THE AUTHOR
Renier is a professional marketing consultant from Fairfax, Virginia. He is passionate about promoting the health and wellness space.