Hormone replacement therapy (HRT) is aimed at eliminating estrogen deficiency in pathological menopause. The medications involved in the therapy contain the analogs of the natural female hormones estrogen and progesterone.
Women go through perimenopause, menopause, and postmenopause at different ages and with different hormone levels, which is why there are specific medicinal products for each stage that differ in terms of composition and the amount of estrogen and progestin.
Perimenopausal HRT is prescribed after a woman reaches age 45 to help her adjust to the decreasing, but still present, menstrual function. As a rule, this improves the woman’s overall health and restores menstruation regularity. In postmenopause (after the age of 50), the therapy is aimed at alleviating such symptoms as hot flashes, sweating, psycho-emotional disorders, and possible postmenopausal diseases in the absence of menstruation.
Menopausal HRT is prescribed by the reproductive endocrinologist in a clinic.
When prescribing hormone replacement therapy (HRT), the reproductive endocrinologist selects a medicinal product taking into account the woman’s indications and contraindications.
The pros and cons should be weighed in each case. There are various drug forms, such as pills, patches, skin gels, vaginal suppositories, and injections. Before the treatment is prescribed, the woman should undergo an examination.
Examination before HRT includes:
- colposcopy and the Pap test
- mammography and/or breast ultrasound
- the complete blood count, the basic metabolic panel, coagulation testing, and blood hormone testing
- electrocardiography (ECG)
There are situations when HRT should not be prescribed, for example, in the case of high blood pressure, diabetes, high risk of thrombosis and heart diseases, breast cancer, and hepatitis. The optimal HT duration is 5−7 years with regular examinations.