One of the keys to understanding why your doctor may have prescribed hormone replacement therapy lies in knowing what health benefits were intended for you. In other words, “What problem were you trying to solve?” The information on this page is designed to give you the simple, plain English version of the hormone story.Which Hormones Need Replacing? Most of the fuss about HRT (Hormone Replacement Therapy) centers around the hormone estrogen. Estrogen is most often associated with women. You’ve probably heard about the hormone testosterone in relation to men and their various impulses. In truth, these hormones are present in both sexes, but in vastly different amounts.Estrogen comes in three forms. Since their names sound almost the same and they’re hard to learn anyway, we won’t even use their formal names. All you need to know is that each is manufactured at a different stage in life.
One type, the most intense, surges during pregnancy. You probably recall the glow of pregnancy and the vast dip in your mood after delivery. Those swings were due in part to this one type of estrogen. Meanwhile, another much weaker type of estrogen is most prevalent prior to menopause, and the third is also weak and most abundant after menopause. So estrogen doesn’t disappear. It’s just that the body manufactures different types at different times, presumably to meet the needs of women at different periods in their lives.
Since the 1960s, and even earlier, medical researchers have theorized that the types of estrogen that tend to decrease after menopause might be the key to keeping a woman youthful and sexually aroused. They theorized further that additional estrogen would keep women healthier in several other ways, including helping to prevent certain types of heart disease and cancers.
How Are Hormones Replaced? While many of the beneficial drugs we take are synthetics—that is, they are produced in labs and are designed to mimic what our bodies are usually able to produce on their own—people tend to feel better about products that they see as “natural.” Of course, tobacco leaves are natural, but smoking them isn’t necessarily healthful!
Other forms of estrogen are available in skin patches, creams, and tablets. Doctors prescribe them in different dosages. Over the last few decades, many women have taken estrogen in combination with progestin, a synthetic drug that mimics the action of the hormone progesterone. The benefit of taking the combination is that progesterone helps balance out the negative effects of estrogen. The medical community embraced this combination when they discovered a rising incidence of endometrial cancer among women who were taking estrogen.
Why Are Hormones Prescribed?
Generally, doctors prescribed HRT for two reasons: to relive the discomforts of menopause and to prevent serious medical conditions.
As you probably know, hot flashes, night sweats, depression, a decreased interest in sex and a number of other annoyances accompany menopause for many women. When these natural events become unbearable, doctors prescribe HRT. Many women feel better on HRT, claiming an increase in energy, better sleep and fewer mood swings. Eventually, the medical community started to see menopause as something of a disease and now refer to the night sweats and other effects as “symptoms” of what has come to be seen as a medical condition.
Additionally, some doctors have prescribed HRT because it was assumed to prevent or greatly reduce the chances of heart disease, the number one killer of women. Furthermore, they assumed that taking HRT would not involve serious health risks, although some research evidence pointed to an increased risk of breast cancer.
If your doctor prescribed HRT, you were probably asked about your family history of heart disease and cancer. If your parents, siblings, or other close relatives had contracted or died of heart disease, then your doctor may have encouraged you to consider HRT. On the other hand, if there was evidence of breast cancer in the women in your family, chances are your doctor avoided hormone replacement therapy or prescribed the hormones in very low doses.