Short Description:
- Preparations: In women, estrogen-progestin preparations, estrogen preparations and tibolone preparations. Men are treated with testosterone preparations.
- Side effects: Hormone replacement therapy can prevent heart attacks, but it can also increase the risk of strokes, blood vessel blockages, and breast cancer. Menstrual bleeding may also occur.
- When is it used: In cases of severe menopausal symptoms.
- Intake and use: gels, patches, injections, tablet, etc.
Hormone replacement therapy: preparations
Various hormone preparations are available to alleviate menopausal symptoms. In rare cases, men also receive hormone replacement therapy. Since hormone replacement therapies contain artificially produced hormones, they require a prescription.
Various preparations are available for hormone replacement therapy during menopause:
- Estrogen-progestin preparations
- Estrogen preparations
- Tibolone preparations
Estrogen-progestin preparations
The hormone levels in the body decrease. As part of hormone replacement therapy, estrogen-progestin preparations can counteract the symptoms associated with hormone decline.
Pure estrogen preparations
Menopausal symptoms are caused by the increasing lack of estrogen. So pure estrogen preparations should be sufficient to counteract the symptoms. Such preparations are actually used in hormone replacement therapy – but only in certain cases.
These can develop into endometrial or uterine body cancer. However, if the estrogen is combined with a progestin, no growths occur. Pure estrogen preparations are therefore only considered in hormone replacement therapy for women who have had their uterus removed.
Tibolone preparations
Hormone replacement therapy for men
In some cases, men also receive hormone replacement therapy. Men’s sex hormone levels also decrease with increasing age, but not as much as women’s. Typical menopausal symptoms are therefore usually absent in men.
However, if the lowered testosterone level in men leads to symptoms such as sexual or metabolic disorders, hormone replacement therapy can be helpful.
Side effects of hormone replacement therapy
Advantages of hormone replacement therapy
Menopause is often accompanied by hot flashes and night sweats. Their number can be significantly reduced with hormone preparations containing estrogen and progestin or estrogen alone. Another effect may be improved sleep in women who were previously often awakened at night by hot flashes.
In addition, hormone replacement therapy is also supposed to protect against other diseases, such as heart attacks. However, some of these assumptions are now considered to be disproven.
What are the risks of hormone replacement therapy?
Side effects can generally occur with all medications, including hormone preparations used in hormone replacement therapy.
At the beginning of the therapy, a weight gain of half a kilo to one kilo is possible. The reason for this is hormone-induced water retention, which disappears again over time. Women who take hormone replacement products therefore do not automatically gain weight. But: women often gain some weight with age – with or without hormone replacement therapy. For detailed information, see the article “Weight gain during menopause”.
Side effects associated with prolonged hormone therapy
More serious are the side effects that occur with prolonged hormone replacement therapy. Depending on the preparation, the risk of various diseases increases:
Estrogen-progestin preparations as well as estrogen-only preparations increase the risk of:
- Stroke
- @ Blood clots in the legs and/or lungs (thromboembolism)
- Gallbladder disease requiring surgery
Prolonged use of tibolone appears to increase the risk of tumor return in women who have had breast cancer. In addition, the risk of stroke could increase in women over 60 years of age.
Because of these serious side effects, menopausal hormone replacement therapy should be used only when absolutely necessary and for as short a time and at as low a dose as possible.
What happens when you stop taking hormones?
Hormone replacement therapy: That’s why it’s used!
Hormone replacement therapy (HRT) aims to relieve menopausal symptoms with the help of hormone preparations. These include hot flashes, night sweats, mood swings, nervous restlessness and sleep disorders.
However, hormone replacement therapy is not intended to restore previous hormone concentrations in the body, but only to specifically reduce estrogen deficiency-related complaints. The term hormone replacement therapy is therefore not entirely correct; “hormone therapy” (HT) would be more accurate.
When do you perform hormone replacement therapy?
Hormone replacement therapy is considered when women suffer severely from menopausal symptoms such as hot flashes and sweating. In general, the treatment is particularly beneficial if it is started as early as possible, with the onset of menopause.
If necessary, hormone replacement therapy is possible until old age. However, the risk of side effects increases with the duration of use.
How do you take hormone preparations?
Hormone replacement preparations are available in different dosage forms. There are estrogen-progestin preparations as a gel (to be applied to the skin), tablet or capsule to be swallowed, as a nasal spray, patch or injection (injection).
Pure estrogen preparations are also available as tablets, cream, patches or injections. The artificial hormone tibolone is available in tablet form.
The exact application of the hormone preparations depends on the dosage form. For example, the tablets usually need to be taken daily. The hormone patch is changed once or twice a week, and the vaginal ring about every three months. The doctor will inform you in detail about the correct use of your hormone preparation.
The doctor prescribes hormone replacement therapy in the lowest possible dosage. The aim is to relieve menopausal symptoms while keeping side effects as low as possible.
Menopause: Treatment without hormones
Whether preparations containing phytoestrogens can actually alleviate menopausal symptoms has not yet been clearly proven, however. In the case of plant estrogens in high doses, even health side effects, for example an increase in the risk of breast cancer, cannot be ruled out. Therefore, always talk to your doctor before using phytoestrogen preparations.
Learn more about menopause, medications and medicinal plants here.
