A password is required to submit a request for an internal transfer. In order to obtain the password you can check any of the following resources: Login to the employee portal, check the current issue of "Regional High Points" newsletter, contact HR, or read this week's "Daily Announcements".
Hormone Replacement Therapy in Women: A Look at the Options
Amy Scholten, MPH
Hormone replacement therapy (HRT) is sometimes used on a short-term basis to relieve unpleasant menopausal symptoms, such as hot flashes, vaginal dryness, and irritability. On a long-term basis, some women have used HRT based on the idea that it would reduce the risk of
heart disease. However, results of studies on estrogen replacement therapy (ERT) and estrogen plus progestin suggest that the risks of long-term HRT may outweigh the benefits for many women.
HRT can include the hormones estrogen alone, or the combination of estrogen and progesterone. If you're considering HRT for the first time, or want to talk to your doctor about changing the regimen you're presently on, here's a rundown of options.
Estrogen Only (ERT)
Therapies containing just estrogen are commonly referred to as estrogen replacement therapy, or ERT. Because of the increased risk of
(lining of the uterus), long-term ERT is usually only offered to women who have had uterus removal through
ERT can be administered in a variety of ways, including oral medications, patches, creams, and gels.
delivers estrogen so that it circulates throughout the body, whereas
delivers estrogen to a particular area of the body, such as the vagina to treat vaginal dryness or vaginal atrophy.
Potential Side Effects of ERT
Uterine bleeding (if uterus is present)
Stomach cramps or abdominal bloating
Swelling of hands, feet, or lower legs due to retaining fluid
Endometrial cancer (if progesterone isn't taken with ERT)
Gallbladder problems, including
(for orally administered ERT)
Estrogen Plus Progesterone (HRT)
Hormone replacement therapy (HRT) is treatment that combines ERT (estrogen only) with a form of the hormone progesterone. This may consist of natural progesterone or a synthetic progesterone, called progestin. Both forms are also called progestogens.
There are several HRT schedules and methods of delivery available, including:
—This treatment provides estrogen for 25 days each month, adding progesterone on the last 10-14 days out of 25, followed by 3-6 days of no therapy. This way, both hormones are "cycled." Cyclic HRT may cause uterine bleeding (a menstrual period) when the progesterone cycle ends. Hot flashes are also more likely to return on the days when no hormones are taken.
—This treatment provides estrogen every day, with progesterone added 10–14 days of each month. Like cyclic HRT, the main side effect is uterine bleeding (in the form of a period).
—This treatment provides both estrogen and progesterone every day. The daily dose of progesterone is much lower than the daily dose in cyclic therapy, which may result in a lower total dose over the course of the month. Breakthrough uterine bleeding occurs in some women on this schedule, but usually stops within the first year of therapy.
—This treatment provides estrogen every day, with progesterone added intermittently in "on-off" cycles. The cumulative monthly dose of progestogen is about half of that of a continuous-combined pattern. .
Potential Risks of HRT
Potential side effects and risks of HRT are basically the same as those listed for ERT. Long-term HRT may slightly, but significantly, increase the risk of
strokes, blood clots, heart attacks, and
breast cancer, gallstones, and gallbladder disease. Adding progesterone, however, eliminates the increased risk of endometrial cancer caused by estrogen alone. This applies to women who have not had their uterus removed.
Benefits, risks, and side effects of ERT, HRT, and NHRT. Project AWARE website. Available at: ...(Click grey area to select URL) Updated September 2012. Accessed July 18, 2014.
Breast cancer in women. EBSCO DynaMed website. Available at: ...(Click grey area to select URL) Updated July 9, 2014. Accessed July 18, 2014.
Estrogen-progestin combinations. EBSCO DynaMed website. Available at: ...(Click grey area to select URL) Updated January 18, 2013. Accessed July 18, 2014.
Estrogens, conjugated. EBSCO DynaMed website. Available at: ...(Click grey area to select URL) Updated December 14, 2011. Accessed August 16, 2012.
FAQ: Hormone therapy. American College of Obstetricians and Gynecologists website. Available at: ...(Click grey area to select URL) Updated April 2013. Accessed July 18, 2014.
FAQs: Hormone therapy basics. North American Menopause Society website. Available at: ...(Click grey area to select URL) Accessed July 18, 2014.
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2010 October 21. Available at: ...(Click grey area to select URL) Updated August 10, 2010. Accessed July 18, 2014.
Hormonal replacement therapy. EBSCO DynaMed website. Available at: ...(Click grey area to select URL) Updated May 2, 2014. Accessed July 18, 2014.
Hormone replacement therapy. American Academy of Family Physicians. FamilyDoctor.org website. Available at: ...(Click grey area to select URL) . Updated March 2013. Accessed July 18, 2014.
Hormone replacement therapy. WomensGuide.org website. Available at: ...(Click grey area to select URL) Accessed July 18, 2014.
Hormones and menopause. National Institute on Aging website. Available at: ...(Click grey area to select URL) Updated March 20, 2014. Accessed July 18, 2014.
Progestins. EBSCO DynaMed website. Available at: ...(Click grey area to select URL) Updated January 18, 2013.
9/16/2008 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Huang A, Yaffe K, Vittinghoff E, et al. The effect of ultralow-dose transdermal estradiol on sexual function in postmenopausal women. Am J Obstet Gynecol. 2008;198:265.e1-7.
11/19/2008 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Buster JE, Koltun WD, Pascual ML, Day WW, Peterson C. Low-dose estradiol spray to treat vasomotor symptoms: a randomized controlled trial. Obstet Gynecol. 2008;111:1343-1351.
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at firstname.lastname@example.org. Our Health Library Support team will respond to your email request within 2 business days.