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What you need to know about hormone replacement therapy

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Vaginal dryness? Hot flashes? Sleep issues? These are all symptoms of menopause — and hormone replacement therapy could help.
Updated on October 4, 2022

If you’re a woman age 45 or older, chances are you’re experiencing some symptoms of menopause or perimenopause. And it’s no walk in the park. Vaginal dryness, night sweats, mood swings, hot flashes — these symptoms can cause discomfort and affect your quality of life. Hormone replacement therapy (HRT) is a way to feel better.

“The replacement of hormones can help with the transition from pre-menopausal to postmenopausal. And it can improve postmenopausal quality of life,” says Amy Richter, MD. She’s an OB-GYN at Suffolk Obstetrics & Gynecology in Port Jefferson, New York.

Talk to your doctor about whether HRT is right for you. Here, we’ll review the common types of HRT so you’ll know what to expect. (And don’t forget to bring this free prescription discount card with you to the pharmacy. It could save you up to 80% on your medications.)

What is hormone replacement therapy?

Before menopause, your ovaries produce estrogen. As you approach menopause, your ovaries stop making estrogen. This drop in estrogen is what causes menopause symptoms. These symptoms can include vaginal dryness, night sweats and hot flashes. With HRT, you take estrogen to replace the estrogen that your ovaries no longer make. You may also take estrogen along with progesterone. HRT remains the most effective treatment for a range of menopause symptoms.

What are the most common ways hormone replacement therapy is delivered?

Estrogen can be delivered in 2 ways:

Systemic estrogen therapy: Systemic estrogen therapy is often the best treatment for hot flashes and night sweats. The estrogen can be delivered via pills, skin patches, gels, rings, creams or sprays, per the Mayo Clinic. Which form you choose is largely a matter of convenience, says Dr. Richter, but talk to your doctor about what’s best for you.

Local estrogen therapy: If you only have vaginal dryness, your doctor may suggest that you try a vaginal tablet, capsule or cream to deliver estrogen directly to the vaginal tissue. There’s also a vaginal ring that lasts for 3 months. Talk to your doctor about the best option for you.

There is also combined hormone therapy

Systemic estrogen therapy can thicken the lining of the uterus, increasing the risk of endometrial cancer. Taking progesterone in addition to estrogen helps reduce that risk.

Progesterone can be delivered:

  • Through pills you take by mouth
  • Through tablets or gel that you place in the vagina
  • Through pills or patches that also contain estrogen (for example, estradiol)

If you are on HRT, you should check in with your doctor every 6 months. They will need to watch the amount of medication you’re on, as well as any symptoms or side effects, says Dr. Richter.

Recommended reading: 5 health conditions every woman should know about.

What are the other benefits of hormone replacement therapy?

In addition to helping with menopause symptoms:

  • Systemic estrogen therapy can protect against bone loss. This condition is common in early menopause.
  • Combined hormone treatment may reduce the risk of colon cancer.

What are the side effects of hormone replacement therapy?

Common side effects include:

  • Vaginal spotting or bleeding, which usually stops within 6 months
  • Temporary breast soreness
  • Bloating (fluid retention)
  • Headaches

Talk to your doctor if you have troublesome side effects. They may be able to change your medication.

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What are some of the most common postmenopausal hormone medications?

The following are the brand names of some (but not all) postmenopausal hormones:


Combination estrogen and progesterone therapy

You don’t have to live with uncomfortable menopause symptoms. There are lots of options that can help. Work with your doctor to find out the best plan for you.

Another thing that could make you feel better? Spending less on medications. Download our prescription coupon app today to see how much you could save.

Additional sources:
HRT FAQs: American College of Obstetricians and Gynecologists
HRT for menopause symptoms: Cleveland Clinic
Is HRT right for you? Mayo Clinic