Women begin the menopausal phase of their lives when their ovaries stop producing eggs and hormone levels fall. The physical and mental challenges that accompany menopause cause many women to look for solutions to replace the lost hormones. Hormone replacement therapy (HRT) has undergone a wide range of critics and followers in all its permutations, report doctors at the Mayo Clinic. A woman needs to weigh the benefits and risks of the various hormone replacement therapy types to make her own decisions about what kinds of HRT are right for her.
Estrogen/Progestin
A combination drug composed of estrogen and progestin is prescribed to a woman who has had her uterus removed. In addition to relieving women of the symptoms of menopause such as hot flashes, mood swings and vaginal dryness, the hormone replacement therapy was thought to provide other benefits. However, researchers at the National Heart Lung and Blood Institute (NHLBI) found that the combination in fact did not reduce a woman's risk of heart attack and actually increased the risk of blood clots. The combination therapy increases a woman's risk for breast cancer and stroke as well. Estrogen/progestin combinations do increase bone density, resulting in a lowered risk for bone fractures.
Estrogen-only
The most common form of HRT is estrogen-only hormone replacement therapy and is the treatment of choice for women who still have a uterus. The products do relieve the uncomfortable symptoms of menopause and also increase bone density. They do carry risks. Findings from the NHLBI 1991 Women's Initiative studies found that HRT consisting only of estrogen caused an increase risk of cardiovascular disease that presents as high blood pressure, obesity and high cholesterol levels.
Bio-identicals
Bio-identicals are custom-made hormones that are touted to mimic the body's natural hormones. They are chemical compounds made by prescription at compounding pharmacies and are based on hormone tests done on a woman's saliva. Doctors at the Mayo Clinic report that bio-identicals are no more or less dangerous than other hormone replacement therapies, though doses can be customized to serve individuals. Because the products are not governed by the Food and Drug Administration, however, there is no way to test them for impurities and prescribed potency, which could lead to complications.
Applications
HRT applications vary as well. Either type of hormone replacement therapy can be taken orally as a pill or liquid medication. Creams and lotions can contain the hormones that are then applied to the skin and reach the blood stream transdermally. Many women choose to use a patch, which also transmits small amounts of hormones through the skin. Hormones also can be delivered through a nasal spray, vaginal cream or ring that's placed in the vagina.
