Hormone Therapy
(Estrogen Therapy, Estrogen/Progestin Therapy)
Medical Author:
Ruchi Mathur, MD
Medical Editors:
William C. Shiel Jr., MD, FACP,
FACR,
Dennis Lee, MDRevising Medical Author:
Carolyn Crandall, MD, MS, FACP
In this article, the term "hormone therapy" or "HT" is replacing the outdated terminology "hormone replacement therapy" or "HRT."
What is menopause?
Menopause is the stage in a woman's life when menstruation stops and
she can no longer bear children. During menopause, the body produces less of the
female
hormones, estrogen and progesterone. After
menopause, the lower hormone levels cause the monthly menstrual periods to stop
and gradually eliminate the possibility of becoming pregnant. These fluctuations in hormone levels can also
cause troublesome symptoms, such as hot flashes (a sudden
sensation of warmth, sometimes associated with flushing, and often followed by
sweating) and sleep
disturbance. Sometimes women experience other symptoms, such as vaginal dryness.
While many women
encounter little or no trouble during menopause, others endure moderate to
severe discomfort.
Does menopause cause bone loss?
The lower estrogen levels of menopause can lead to
progressive bone loss that is especially rapid in the first five years after
menopause. Some bone loss in both men and women is normal as people age. Lack of
estrogen after menopause adds another strain on the bones in addition to the
usual age-related bone loss. When bone loss is severe, a condition called
osteoporosis weakens
bones and renders them susceptible to breaking. For more, please read the osteoporosis
article.
What are estrogen therapy and hormone therapy (HT)?
Estrogen, in pill,
patch, or gel form, is the single most effective therapy for suppressing hot
flashes.
The term estrogen therapy, or ET, refers to estrogen
administered alone. Because ET alone can cause uterine cancer
(endometrial cancer) (see below), a
progestin is
administered together with estrogen in women who have a uterus to eliminate the
increased risk. Thus, the term estrogen/progestin therapy, or EPT, refers to a
combination of estrogen and progestin therapy, as is given to a woman who still
has a uterus. This method of prescribing hormones is also known as combination
hormone therapy.
The term hormone therapy (HT) is a more general term
that is used to refer to either administration of estrogen alone (women who have
had a hysterectomy), or combined estrogen/progestin therapy (women with a uterus).
All
forms of hormone therapy (HT) that are FDA-approved for therapy of hot flashes are similarly
effective in suppressing hot flashes.
Next: What are the side effects and risks of hormone therapy (HT)? »