After menopause the production of estrogen and progesterone in women decrease causing many changes in a woman’s body. These changes are associated with a higher risk of some diseases and they make it more difficult to control blood sugar levels. Therefore, the hormone replacement therapy (HRT) is prescribed to replace the hormones that the body is no longer producing. Hence, the symptoms of the climacteric are improved and so are the biological changes in the woman’s body.
Therapy can begin before menopause (peri-menopause) or afterwards depending on the medical history of each woman. It is important to point out that this therapy should be individualized, taking into account the personal condition of each woman.
Who should not be treated with hormones for menopause?
- Women with vaginal bleeding. They should be evaluated by their Gynecologist to establish the possible causes.
- Women who have suffered from cancer. Some cancers are associated with female hormones (estrogen and progesterone) and therefore if they are treated with HRT the risk of relapse increases.
- Women who have suffered a stroke, a heart attack or thrombosis.
- Women who have liver disease.
How is hormone replacement therapy administered?
According to the American Medical Association, HRT can be administered by various methods, including:
- Systemic treatment: this is based on the use of either estrogen alone (for a woman without her uterus) or a combination of estrogen plus progesterone (for a women with her uterus).The treatment can be given by different modalities:
- Orally: it is given on a daily basis and can cause vaginal bleeding.
- Patches: are placed in the abdomen area or on the buttocks. Hormones are released and absorbed through the skin.
- Topical creams: These are absorbed through the skin.
- Low-dose vaginal treatment: Estrogen creams or pessaries that are inserted into the vagina or used locally around the vulva to help with vaginal dryness and urinary problems. These products act topically and provide no relief for hot flashes, night sweats, or bone protection.
Some studies show that HRT reduces the body mass index, waist circumference and improves glycemic control. Also, it helps control menopausal symptoms (hot flashes, vaginal dryness, and sweating). For this reason, HRT is suitable for use in diabetic women.
However it is important to make a balance between risks and benefits and decide together with your physician the best treatment course for you.