Menopausal hormone therapy (MHT), also known as postmenopausal hormone therapy and hormone replacement therapy, is a treatment that doctors may prescribe to treat common menopausal symptoms as well as long-term biological changes caused by low levels of the natural hormones estrogen and progesterone in a woman’s body during and after menopause.
For MHT, women who have not had a hysterectomy are commonly given estrogen and progestin. This is because, whereas estrogen alone is linked to an increased risk of endometrial cancer, estrogen in combination with progestin is not. Estrogen is only used alone in women who have had a hysterectomy.
Hormones in HRT vs. Natural Hormones
Hormones used in HRT can be sourced from a variety of plants and animals or manufactured in a lab. These hormones have a chemical structure that is similar to, but not identical to, hormones produced by the female body.
Non-FDA-approved hormone products (bio-identical hormones) are sometimes marketed and sold on the web and depending on the dispensary, anyone can purchase HRT products without a doctor’s prescription. Online pharmacies offer MHT claiming their products are safe and contain all-natural ingredients. FDA-approved hormonal therapies are unsubstantiated by scientific evidence.
Hormone Replacement Therapy for Breast Cancer Survivors
Women who have had breast cancer should not use HRT unless otherwise prescribed as a treatment. The therapy is ineffective and menopausal symptoms can render their quality of life unacceptable. The surgeon or oncologist should only recommend HRT in these circumstances.
The proof is not conclusive but some believe HRT will heighten the risk of getting breast cancer. Not only that, but it increases the risk of it recurring in breast cancer survivors. Progestogen and oestrogen can stimulate breast cells and some kinds of hormone replacement therapy are linked to breast cancer in women who haven’t had cancer before.
Bonus Benefits of HRT
Hormone replacement therapy lessens the risk of chronic conditions that can affect postmenopausal women, including:
- Diabetes. Taking HRT throughout menopause diminishes a woman’s chance of contracting diabetes.
- Osteoporosis. HRT prevents bone density loss, protecting bone integrity and reducing the risk of strains, sprains, or fractures. Except in younger women going through menopause, HRT is not the first choice of treatment for osteoporosis.
- Bowel Cancer. HRT slightly decreases the chances of having colorectal cancer or bowel cancer.
- Cardiovascular Disease. Hormone replacement therapy may reduce the possibility of cardiovascular disease when used during menopause.
HRT and Weight Gain
Weight gain during menopause is probably related to age and lifestyle. An uptick in body fat, especially around the midsection, can occur during menopause because of hormonal changes. It’s normal to experience a decrease in muscle tissue because there’s less activity and exercise. These factors contribute to weight gain.
Most studies do not show a link between weight gain and HRT. If a woman is going to gain weight generally she’ll do it while going through her middle years, whether or not she uses HRT.
Some women may encounter symptoms at the start of treatment, including bloating, fluid retention, and breast fullness, which someone could mistake as weight gain. These symptoms usually disappear once the doctor adjusts the doses to accommodate the individual.
Contraception and Hormone Replacement Therapy
HRT is not a form of prophylactics. The treatment doesn’t have enough levels of hormones to suppress ovulation, so pregnancy is still possible even in women going through perimenopause. Periods can be erratic in perimenopause, and women won’t produce eggs as frequently, but it’s still possible until she reaches menopause. For women not yet yet 50, doctors recommend using contraception for at least the first two years after her last period.