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Hormonal Replacement Treatment

Hormone Replacement Therapy or (HRT) is the treatment with different types of estrogen for conditions such as Menopause, osteoporosis, and other conditions.

During Menopause a decreased amount of Progesterone and Estrogen can cause several symptoms and adverse effects,

Hormonal Replacement Treatment may use 1 or both hormones in order to increase the amount that is within the body.

Other hormones considered are progestins and testosterone

Treatment value has changed since 2002

“Women’s Health Initiative” and “National Institutes of Health” have both placed risks with taking hormone replacement therapy

It was seen that increased risk of Breast Cancer , Heart Attack and  Strokes were seen by those who were taking Prempro.

A confirmation study done in the United Kingdom called “The millon women study“.

Therefore, the symptoms should outweigh the risks

Usage of HRT has almost dropped in half over the last few years

Uses:

1.)  Surgical menopause
2.)  Perimenopause
3.)  Postmenopause

In Britain HRT is also referred to as Hormone therapy or HT

Surgical menopause –  those patients may comfortably use HRT for years until the age of natural menopause

Perimenopause –  Small doses for 1-2 years are recommended with treatment that rarely exceeds 5 years

Postmenopause – Treatment occurs rarely and on an individual basis

Types:

1.)  Conjugated Equine Estrogens

Premarin

–  Available in oral, IV, and topical forms
–  Types of estrogen [estrone, equilin, and equilenin]
–  From the urine of pregnant mares

Uses:  Surgical menopause, symptoms from menopause, metastatic breast cancer in men, prostate cancer

2.) Bioidentical hormone replacement therapy

Estradiol
Progesterone

–  Is argued group of medications that replaces hormones in women
–  Are not animal derived or invented molecules
–  Are customed mixed by a pharmacist from a doctor’s prescription
–  Uses:  Menopause

Contraindications of HRT

1.)  Pregnancy
2.)  Liver Disease
3.)  Coronary Artery Disease
4.)  Venous Thrombosis
5.)  Endometrial Cancer
6.)  Vaginal bleeding  [Undiagnosed]

Potential Contraindications

–  Migraines
–  Uterine fibroids
–  Personal history of breast cancer
–  others

Side Effects

–  Headaches
–  Acne
–  Diarrhea
–  Abdominal pain
–  Abdominal cramping
–  Skin pigment changes
–  Change in sex drive
–  Swelling
–  Breast changes: pain, swelling, discharge, others
–  others