Dr. Deanna is well-versed in hormone health and Hormone Replacement Therapy. She has received extensive training in advanced hormone health treatment.
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What Is HRT?
HRT stands for Hormone Replacement Therapy and is used interchangeably with Hormone Therapy (HT) and Menopausal Hormone Therapy (MHT). The hormones that I prescribe are bio-identical, meaning they are structurally identical to hormones made in the human body. The benefit of using bio-identical forms is that the body is able to freely recognize and use these compounds to their maximum potential. These hormones are often derived from plant or food sources.
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What Hormones Are Involved?
The most common protocol for hormone therapy is a combination of topical estradiol and oral progesterone. Topical testosterone and oral DHEA can also be used in women although would be an off-label indication. The combination and forms of hormones depend on your individual risk factors, preferences and whether you have a uterus.
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What Are Some Of The Benefits Of HRT?
Some of the benefits you will notice with HRT include:
- Reduced or resolved hot flashes
- Improved sleep quality
- Improve mood and motivation
- Increased energy and focus
- Reduced heavy menstrual bleeding or irregular bleeding
- Reduced or resolved vaginal dryness
- Reduced or resolved pain with intercourse
- Improved libido
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Who Can Benefit From HRT?
The most benefit is seen in perimenopausal women, when hot flashes and sleep difficulties become the most prominent. Post-menopausal women can also benefit if symptoms persist, particularly vaginal symptoms. HRT can often safely be used within 10 years of your last menstrual period.
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Is HRT a Safe Treatment Option?
Hormone replacement has come a long way since its initial use. The main concerns with hormone replacement include your risk of blood clots, breast cancer and endometrial cancer. These risks are influenced by the form of hormone, the combination of hormones used and the length of time you are on them. There is an increased risk of blood clots with ORAL estrogen and in contrast, TRANSDERMAL (topical) estrogen, such as in a cream, gel or patch, there is no risk for blood clots. The risk of breast cancer is determined by the addition and type of progestogen (bio-identical or synthetic). Added oral progesterone (bio-identical) is required to prevent endometrial cancer in women with a uterus and has a neutral effect on breast cancer risk. In contrast, the addition of a progestin (synthetic) has been shown to increase breast cancer and clotting risk, regardless of the type of estrogen used. In summary the combination of transdermal estrogen WITH oral progesterone has a neutral effect on blood clot, breast cancer and endometrial cancer risk. It is important to determine each individual baseline risk factor before determining if you are a good candidate for HRT. HRT is the most beneficial when commenced early in the perimenopausal phase when most women become symptomatic. It is important to note that there are added cardiovascular risks if starting HRT in the late post-menopausal phase or greater than 10 years from your last menstrual period.
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