How To Get Started On Hrt
Speak to your local GP practice if you’re interested in starting HRT.
You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first. However, a blood test to measure your hormone levels may be carried out if you’re aged 40 to 45. Blood tests may also be carried out to help diagnose suspected premature menopause if youre under 40 and have menopausal symptoms.
Your GP can explain the different types of HRT available and help you choose one that’s suitable for you.
How Long Does Hrt Take To Work Understanding The Healing Process
When youre struggling with the symptoms of ahormone imbalance or age-related hormone changes, you want relief fast. Afterall, the physical and emotional toll of these phenomena can be significant andseverely compromise your comfort, your functionality, and even your long-termhealth.
Today, hormone replacement therapy is widely recognized as the best treatment for a wide range of hormone-related issues, from menopause symptoms to the effects of low testosterone. Once you decide to take HRT, its natural to want to see results fast. So how long does HRT take to work?
HRT can be an effective, safe, and sustainabletreatmentbut it doesnt work overnight. While some patients notice the effectsof treatment relatively quickly, improvements typically happen over the courseof weeks and months. And when you work with an HRT specialist, its impact canlast a lifetime.
What Are Some Commonly Used Postmenopausal Hormones
The following list provides the names of some, but not all, postmenopausal hormones.
- Pills, Brand names: Cenestin®, Estinyl®, Estrace®, Menest®, Ogen®, Premarin®, Femtrace®.
- Creams, Brand names: Estrace®, Ogen®, Premarin®.
- Vaginal ring, Brand names: Estring®, Femring® .
- Vaginal tablet, Brand names: Vagifem®. Imvexxy®
- Patch, Brand names: Alora®, Climara®, Minivelle®, Estraderm®, Vivelle®, Vivelle-Dot®, Menostar®.
- Spray, Brand name: Evamist®.
- Modest improvement in joint pains.
- Lower death rate for women who take hormone therapy in their 50s.
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Venous Thrombosis And Hrt
Venous thromboses are blood clots that form inside veins. Women under 50 years of age, and women aged 50 to 60, face an increased risk of venous thrombosis if they take oral HRT. The increase in risk seems to be highest in the first year or two of therapy and in women who already have a high risk of blood clots. This especially applies to women who have a genetic predisposition to developing thrombosis, who would normally not be advised to use HRT.
Limited research to date suggests the increased risk of clots is mainly related to combined oestrogen and progestogen in oral form, and also depends on the type of progestogen used. Some studies suggest a lower risk with non-oral therapy or tibolone.
Types Of Studies Of Hormone Therapy And Cancer Risk
Different types of studies can be used to look at cancer risk from menopausal hormone therapy .
Randomized controlled trials: In this kind of study, a group of patients get the drug being studied , and another group gets a placebo . Results from this kind of study are powerful because which group a patient is in is based on chance. This helps assure that the groups are similar in all ways, such as risk for cancer, except for the drug thats being studied. This is the best way to see the effects of a drug. These types of studies can also be double-blinded, which means neither the people in the study nor their doctors know which group they are in. This lowers the chance that thoughts or opinions about treatment could affect the study results. Unfortunately, these kinds of studies are costly, which limits the number of people in the study, how long the study can continue, and the number of studies done.
A major drawback of observational studies is that the people getting the treatment being studied may have different cancer risk factors than the people who arent. Plus, the treatment can differ between the people being studied. This makes it less clear that the differences seen are only due to the drug being studied and not other factors.
When observational studies and randomized controlled trials have different results, most experts give more weight to the results of the randomized controlled trial.
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How Can I Manage Coming Off The Various Types Of Hrt Medication
A worthwhile exit plan is key to ensuring that your body gets the support that it needs as you prepare for the HRT withdrawal process. While it is amazing how powerful and resilient your body is when it comes to creating stability within all of its complex systems, theres only so much it can do on its own. Without an adequate care plan, there is a high that symptoms will recur.
A rich, nutritious diet is the first step to achieving a healthy hormonal balance. Getting essential vitamins and minerals is vital if you want to look and feel your best during and after menopause. This includes eating a wide range of colorful fruits and vegetables, eggs and dairy products, oily fish such as salmon, and lean protein from chicken or beef. Also, think about how you can naturally boost your estrogen levels by eating foods that are hormone-rich, such as flax seeds, soy, dry fruits, and nuts.
A well-functioning digestive system is also important in achieving a good quality of life during menopause. After all, your gut is where all the essential nutrients are absorbed into the body, so it needs to be working at its optimum rate to minimize menopausal symptoms. Follow a balanced diet that includes sufficient fluids and fiber, as well as maintaining a healthy weight by getting enough exercise every day. To give your gut that extra boost, it may be worth eating probiotic-rich foods or taking a daily supplement with your meals to replenish the levels of good bacteria.
What Are The Benefits Of Mrt
Without treatment, menopausal symptoms such as hot flushes, night sweats, sleep problems and headaches may last for a few years. Most women manage their menopause symptoms themselves, but some may need help from their doctor. MRT has been found to:
- reduce the number and severity of hot flashes and night sweats
- improve symptoms of vaginal dryness and soreness
- help to reduce recurrent urine infections
- lower the risk of osteoporosis, because oestrogen slows bone thinning and helps increase bone thickness
- slightly reduce the risk of diabetes.
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What Is Known About Hormone Therapy And The Risk Of Breast Cancer
Taking combined hormone therapy can increase your risk of developing breast cancer. Here are some important findings:
- Taking combination hormone therapy showed a rare increase of absolute risk of less than one additional case of breast cancer per 1000 person years of use.
- There was a nonsignificant reduction in breast cancer seen in women with hysterectomies on estrogen only therapy.
- If youve been diagnosed with breast cancer you should not take systemic hormone therapy.
Whats Involved In Taking Hormonal Therapy For Acne
These medications must be prescribed by a doctor. Each is a pill that you would take daily.
If youre wondering whether hormonal therapy could help clear your acne, you may want to make an appointment to see a dermatologist. After examining your acne and gathering the necessary information about your health, this doctor can tell you if hormonal therapy may be an option.
Before you see a dermatologist, it helps to prepare for your appointment. Youll want to be able to tell your dermatologist the following:
Medical conditions you have , including high blood pressure, heart disease, blood clots, migraines, or cancer
Medications you take
Supplements and other natural products you take
Surgeries youve had
Medical conditions of close blood relatives, including cancer, kidney disease, or heart disease
If the pill is an option for you, you will have your blood pressure taken to rule out high blood pressure. You dont need a Pap smear or pelvic exam before a dermatologist can prescribe the pill to treat acne.
Before your dermatologist prescribes spironolactone, you will need some blood tests.
If you begin hormonal therapy, you will need to keep follow-up visits with your dermatologist. Spironolactone requires that you gradually increase the dose, so youll need to see your dermatologist every 4 to 6 weeks when you start taking it.
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Important Information About All Medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Never keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading and references
Why Bioidentical Hormones Could Be Banned In The Near Future
If you are reading this blog, you are most likely interested in natural hormones and other therapies as a way of maintaining your health. Perhaps you have used some or all of the bioidentical hormones I mention above. And maybe you even prefer these proven therapies over prescription drugs and over-the-counter medications to treat illnesses.
If so, here is something you need to know: On July 9, 2020, the FDA made an announcementseemingly out of the bluestating that bioidentical hormones are a public health concern and that a ban is likely. This statement could not be more false. All estrogensbioidentical includedthat bind to the alpha estrogen receptor can act as growth promoters in estrogen-sensitive tissue, including breast and uterine tissue. This is why some women prefer herbal approaches instead. However, bioidentical hormones have long been found to be safer and more effective than their pharmaceutical counterparts. In fact, a review of the studies found that compounded bioidentical hormone therapy is associated with lower risks of breast cancer and cardiovascular disease and is more effective than synthetic or animal-derived hormones. And there are many women who have comfortably stayed on low doses of bioidentical hormones for years with great results.
Finally, the committee recommends increased oversight of traditional pharmacies by the federal government and the State Boards of Pharmacy to ensure quality standards for every cBHT preparation dispensed.
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Vikram Sinai Talaulikar Md Mrcog
Clinical Fellow, University College London Hospital, London, UK
Menopause, sometimes referred to as the change of life, happens when a woman’s periods stop permanently signalling the end of reproductive function. Menopause usually occurs when a woman is in her 50s , but some women may experience menopause in their 30s or 40s.For most women, menopause is not an illness, but a phase of natural transition in later life. Sometimes this change can be associated with symptoms that can be distressing. Such symptoms may last for several years. Treatment for menopausal symptoms includes hormone replacement therapy . This can work well, but it increases the chance of some health problems. Every woman needs to consider the benefits and risks of HRT carefully and decide whether to take it.
What happens in the menopause?
What is HRT?
HRT stands for hormone replacement therapy. It is also abbreviated as MHT for menopausal hormone therapy. It consists of the hormone estrogen either alone or combined with the hormone progesterone or therapy with other drugs such as tibolone. The aim is to replace some of the actions of estrogen that the body has stopped making at menopause.Not every woman who experiences menopausal symptoms needs treatment. Some women find that the symptoms do not bother them much, while others find them very distressing and affecting their quality of life. Most symptoms will pass within 25 years, although vaginal dryness is likely to get worse if not treated.
Other Treatments For Menopausal Symptoms
Studies have shown that some prescription medications can reduce hot flushes and sweats. These treatments may be an option if HRT cannot be used for health or other reasons, and should be discussed with a doctor.
The herbal medicine, black cohosh, may take the edge off hot flushes and sweats, but there is no data to support long-term use. There is also a rare liver condition that may be associated with the use of black cohosh.
Other complementary and alternative medicines have not been shown to be effective for menopausal symptoms when compared with dummy or placebo treatment in research studies.
Commercially available vaginal moisturisers may reduce vaginal dryness if used regularly. Consult your doctor about what will work best for you.
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How Should This Medicine Be Used
Hormone replacement therapy comes as a tablet to take by mouth. It is usually taken once a day. To help you remember to take hormone replacement therapy, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take this medication exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Do not stop taking this medication without talking to your doctor.
Activella, FemHrt, and Prempro come as tablets containing estrogen and progestin. Take one tablet every day.
Ortho-Prefest comes in a blister card containing 30 tablets. Take one pink tablet once daily for 3 days, then take one white tablet once daily for 3 days. Repeat this process until you finish all the tablets on the card. Begin a new blister card the day after you finish the last one.
Premphase comes in a dispenser containing 28 tablets. Take one maroon tablet once daily on days 1 to 14, and take one light-blue tablet once daily on days 15 to 28. Begin a new dispenser the day after you finish the last one.
Before taking hormone replacement therapy, ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient and read it carefully.
Experts Answer: Is Hormone Replacement Therapy Safe
30 May 2013
Each week, MyHealthNewsDaily asks the experts to answer questions about your health.
This week, we asked gynecologists, endocrinologists and oncologists: Is hormone replacement therapy safe? Hereâs what they said.
Dr. K. Flood-Shaffer, associate professor in the department of obstetrics and gynecology at the University of Cincinnati in Ohio:
âUnfortunately, there is no simple yes or no answer to that question. But the good news is that there is definitely a place a safe place for hormones. The Womenâs Health Initiative Study , which began to provide good data in 2004, was the first study to slow the unfettered use of hormones in the United States. The data is still being gathered and that is why there is so much confusion on the matter.
âThat being said, hormones are also NOT a âforeverâ medication. Women who have a clear cut indication for hormones and no contraindications , the careful, judicious and temporary use of hormones is considered safe. Women must see their gynecologist, family physician or internist to discuss their own personal situation and risk factors and have a very individualized plan devised for them under close supervision with their physician.â
Dr. Joseph Ragaz, medical oncologist and clinical professor of medicine in the School of Population & Public Health at the University of British Columbia in Canada:
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Healthier Teeth And Gums
Recent studies have shown that HRT can help you get healthier teeth and gums. The loss of bone density that comes with aging can cause teeth to become loose, and as we age, our teeth also become more susceptible to disease. However, when women take hormone replacement drugs, theyre much less likely to experience periodontitis, which is the underlying cause of bone and tooth loss. The improvement in oral health is likely due to the prevention of osteoporosis through HRT.
How To Talk To Your Doctor
I receive letters almost daily from women who have taken the initiative to offer their health care providers information on bioidentical hormones. If you want to use bioidentical hormones as replacement therapy, here are the salient points to know and share with your doctor about bioidentical hormones:
- They have been prescribed by doctors for many years.
- They are readily available through formulary pharmacies.
- They are easily titrated to suit a womans individual needs.
- They are readily absorbed and utilized.
- They are safe and effective.
Many formulary pharmacists work in partnership with physicians to provide individualized hormone-replacement solutions. You may want to call a local formulary pharmacy to consult with a knowledgeable pharmacist to develop your customized plan.
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Editorial Sources And Fact
Hrt Does Not Cause Weight Gain
Weight gain at the menopause is related to age and lifestyle factors. An increase in body fat, especially around the abdomen, can occur during menopause because of hormonal changes, although exactly why this happens is not clear. Normal age-related decrease in muscle tissue, and a decrease in exercise levels, can also contribute to weight gain.
Most studies do not show a link between weight gain and HRT use. If a woman is prone to weight gain during her middle years, she will put on weight whether or not she uses HRT.
Some women may experience symptoms at the start of treatment, including bloating, fluid retention and breast fullness, which may be misinterpreted as weight gain. These symptoms usually disappear once the therapy doses are changed to suit the individual.
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