Hormone Replacement Therapy

In the years leading up to menopause, which is medically defined as 12 consecutive months of not having a period, many women experience a long list of unwanted and unpleasant symptoms. These are the direct result of fluctuations in the female reproductive hormones, estrogen and progesterone. The same symptoms can also occur due to a decrease in hormones following a hysterectomy that includes removal of the ovaries.

 As a woman's production of estrogen and progesterone decreases, she can experience a wide range of symptoms, including:

• Hot flashes
• Night sweats
• Insomnia
• Bladder control issues (urinary incontinence)
• Vaginal dryness
• Low libido
• Joint and muscle pain
• Brain fog
• Headaches
• Irritability
• Mood Changes
• Weight gain
• Frequent urinary tract infections
• Fatigue

The Women's Group team recommends lifestyle changes as the first-line treatment option for symptoms related to hormone fluctuations, and in most cases, these changes provide relief. However, when they don't and symptoms are severe, hormone replacement therapy may be prescribed. Hormone replacement therapy is a replenishment of the decreased hormones in the body, and these hormones must be carefully measured to be returned to each woman's healthy, pre-symptomatic levels.

Hormone therapy is available in a variety of forms to fit each patient's needs and preferences. Systemic options include oral pills, skin patches, and topical gels or sprays, all of which deliver hormones throughout the body to help relieve widespread symptoms such as hot flashes and night sweats. For symptoms localized to vaginal dryness or painful intercourse, low-dose vaginal estrogen, available as creams, rings, or tablets, delivers hormones directly to the affected tissue with minimal absorption elsewhere in the body. Vaginal estrogen can also help relieve urinary symptoms, including frequent urinary tract infections and bladder control issues. Our providers will help determine which delivery method best fits your symptoms, lifestyle, and health history.

Hormone replacement therapy is not recommended for women who have certain health conditions or risk factors, including:

• A history of breast cancer or other hormone-sensitive cancers
• Undiagnosed vaginal bleeding
• A history of blood clots, stroke, or heart attack
• Liver disease
• Pregnancy

Women who smoke or have uncontrolled high blood pressure may also face increased risks with hormone replacement therapy and should discuss their individual risk factors with their provider. Because every patient's health history is different, our team carefully evaluates each woman's candidacy for hormone replacement therapy on an individual basis.