Types of Hormone Replacement Therapy: In females, the levels of estrogen and progesterone fluctuate throughout each month, contributing to the menstrual cycle.
Perimenopause
The levels of estrogen and progesterone start to decline in most females when they’re in their 40s. Menstruation may still continue for some time during this period. Menstruation may become less regular, and some menopause symptoms may start to occur.
It is still possible to become pregnant during this period, although the chances of getting pregnant reduce with time.
Perimenopause usually lasts for about 7 years, but it can also occur for up to 14 years in some women.
Menopause
Menopause usually begins 12 months after a woman’s last period. On average, menopause occurs at the age of 52. Menopause can begin earlier than this for some women. During menopause, menstruation stops in a woman and she can no longer get pregnant naturally.
Women in their menopausal stage usually experience various symptoms of menopause including hot flashes, mood changes, vaginal dryness, low libido, depression, and others.
Women experiencing symptoms of menopause can find relieve and improvements in their symptoms by having hormone replacement therapy.
Hormone replacement therapy (HRT) is a treatment used to increase or balance low hormonal levels, and to relieve symptoms of menopause.
Types of Hormone Replacement Therapy
There are various types of hormone replacement therapy. Some types of hormone replacement therapy contain both progesterone and estrogen. Other types contain only estrogen while some others contain testosterone.
Most women take a combination of the hormones estrogen and progesterone. Some may take only estrogen.
Common types of HRT include:
1. Estrogen-only HRT
A doctor may recommend estrogen-only to a woman if her uterus and ovaries have been removed. Progesterone is not necessary in this case.
2. Cyclical, or sequential HRT
A doctor may recommend this option if symptoms occur before menopause.
3. Continuous combined HRT
A doctor may prescribe a continuous combination of estrogen and progesterone after menopause.
Ways of Taking HRT
HRT can be taken in the form of tablets, skin patches, gels, pellets, vaginal creams, or rings
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Tablets
One of the most common forms of HRT is tablets. These tablets are usually taken once a day.
Both estrogen-only and combined HRT are available as tablets. While some women prefer to have tablets, there are some risks that may occur from taking tablets. The risk of blood clots is higher with tablets.
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Gel
Gel is an increasingly popular form of HRT. Gel is rubbed onto the skin once a day.
Gel is a convenient way of taking HRT. It does not increase your risk of blood clots.
Women who still have womb will need to take some form of progestogen separately to reduce the risk of womb cancer.
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Pellets
HRT is also available as small pellets. The pellets are implanted under your skin around the upper hip area.
The pellets release estrogen gradually and consistently. Pellets may be a convenient option if you don’t want to tablets every day.
Women who still have wombs will need to take progestogen separately to reduce the risk of womb cancer.
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Skin patches
HRT is also available as skin patches. You stick the skin patches to your skin. They need to be replaced every few days.
Oestrogen-only and combined HRT skin patches are available. If you don’t want to take tablets every day, skin patches may be a better option.
Skin patches don’t increase the risk of blood clots.
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Cream
HRT is also available as a cream. You can rub the cream on your skin. It is a convenient way of receiving HRT.
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Ring
HRT is also available as ring. You will need to place the ring inside your vagina. Ring can help relieve vaginal dryness. However, it will not help with other symptoms such as hot flushes.
You can use ring even if you still have a womb and without taking progesterone. It does not carry the risks of HRT and does not increase the risk of breast cancer.
HRT Treatment Routines
You need to consult with your doctor to help you choose which way to taking HRT is best for you.
Your treatment routine depends on whether you’re in the early stages of the menopause or later stages. It also depends on if you have been experiencing symptoms of menopause for a while.
There are two main types of HRT treatment routines. These are cyclical or sequential HRT and continuous combined HRT
1. Cyclical HRT
Cyclical or sequential HRT is often recommended for women taking combined HRT. It is often recommended for women experiencing symptoms of menopause but still have their periods.
There are 2 types of cyclical HRT:
Monthly HRT
For this, you will need to take estrogen and progesterone every day for the last 14 days of your menstrual cycle.
Monthly HRT is usually recommended for women having regular menstruation.
3-monthly HRT
For this, you will need to take estrogen and progestogen every day for around 14 days every 3 months.
3-monthly HRT is usually recommended for women having irregular menstruation.
2. Continuous combined HRT
Continuous combined HRT is usually recommended for women in their postmenopausal stage. A woman is usually regarded to be in her postmenopausal stage if she has not had a period for a year.
Continuous combined HRT involves taking estrogen and progestogen every day continuously.
