Hormone Replacement Therapy (HRT)

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What is HRT?​

Hormone replacement therapy are medications used to replace female hormones (oestrogen and progesterone) that are depleted in the body and are no longer produced by the body during menopause. 2; 3

​HRT should generally be started two to three years of menopause. HRT can be in the form of cream or gels, vaginal rings, tablets or skin patches. 1

Indications for HRT 1

  • Treatment of menopause symptoms.
  • To prevent osteoporosis in older women (>55 years) and bone loss in women with premature menopause (<40 years).
  • Symptoms which indicate urogenital atrophy.

Contraindications 1​

  • History of thromboembolism.
  • Thrombophilia.
  • History of chronic heart disease or stroke.
  • Current or history of breast, endometrial or other oestrogen dependent cancers.
  • Liver disease.
  • Undiagnosed persistent urinary tract bleeding.
  • Hypertension that is untreated.
  • Porphyria.
  • Severe migraines.

Complications 3

  • Heart disease.
  • Stroke.
  • Blood clots.
  • Breast cancer.

Side effects of HRT 3

  • Breast tenderness.
  • Breakthrough bleeding.
  • Bloating.
  • Nausea.

Lifestyle changes when on HRT 2

  • Sensation of smoking.
  • Healthy lifestyle which should include eating a balanced diet, eating healthy, managing stress and any other chronic conditions you may have such as cholesterol.
  • Limit the alcohol that you consume.
  • Wearing loose clothing.

References​

  1. Johannesburg Hospitals, University of the Witwatersrand, Department of Gynaecology. 2017. Wits Gynaecology. South Africa: Department of Obstetrics and Gynaecology.
  2. Brazier, Y. [Internet]. What you need to know about HRT. United Kingdom: Healthline Media; [updated 2017 May 25; cited 2019 Aug 14]. Available from: https://www.medicalnewstoday.com/articles/181726.php.
  3. Mayo Clinic Staff [Internet]. Hormone therapy: Is it right for you?. America: Mayo Clinic; [updated 2018 May 24; cited 2019 Aug 14]. Available from: https://www.mayoclinic.org/diseases-conditions/menopause/in-depth/hormone-therapy/art-20046372.
  4. Renew Health and Wellness [Internet]. Bio-identical Hormone Replacement Therapy or BHRT. United States: Renew Health and Wellness; [cited 2019 Sep 11]. Available from: https://www.renewmetoday.com/bio-identical-hormone-replacement-bhrt/.
  5. Woller, S. [Internet]. HRT Drug Boost: Women on hormone replacement therapy are living longer as menopause treatment cuts death risk by 30 %. United Kingdom: The Sun; [updated 2018 May 25; cited 2019 Sep 11]. Available from: https://www.thesun.co.uk/uncategorized/3045401/women-on-hormone-replacement-therapy-are-living-longer-as-menopause-treatment-cuts-death-risk-by-30/.